April 7, 2018 is a special day. It is World Health Day and the 70th anniversary of the World Health Organization (WHO).
Each year, the organization creates a new theme and slogan. This year’s theme is “Universal Health Coverage: everyone, everywhere.” The current slogan is “Health for All.”
The founding of the World Health Organization was behind the principle in which every person on earth has the right to have the highest health level possible. This guiding principle has been observed by the organization for 70 years and is the driving force in supporting countries worldwide to make Universal Health Coverage (UHC) their goal.
When there is strong political will, UHC can be achieved, hence, the organization is again knocking on the doors of world leaders so they can make good on their promise last 2015 and establish actionable steps for the advancement of people’s health. This means that every person can access needed health care services without putting financial burden on the individual.
The WHO plans a series of events for the entire year, starting on April 7. Local and global dialogues on how to achieve health for everyone are on the agenda. Campaign materials, policy advocacy and other information materials are available in six languages from the website of the World Health Organization.
Plans for the year
For the 70th anniversary of the WHO and to further the aims of universal health care, the organization plans to inspire, motivate and guide world leaders to make their commitments to UHC more concrete.
They plan to inspire by focusing on the power of the policy makers to change their nation’s health, motivate them by sharing other nations’ progress and successes and guide them by providing tools on how to make domestic policies through methods that work.
What is Universal Health Care?
Universal health care (socialized health care, universal care, universal coverage or universal health coverage) is a particular country’s health care system involving the provision of health care and financial protection to its citizens.
It offers a specific benefits package to all citizens of a specific country with the objective of providing improved health outcomes, improved access to healthcare services and financial protection.
While the term is ”universal” it does not mean that the health care coverage is the same for every person. UHC is decided based on three categories – person covered, services covered and the cost of covered services. The UN member nations agreed to achieve the goal of the UHC by 2030.
Why is universal health care important?
It was determined long ago that countries implementing universal health care make very good investment in their human resources. Healthy people mean a healthy nation, physically and economically. When citizens of a country are able to have access to quality healthcare that do not put too much of a drain on their financial resources, their health and life expectancies improve. Likewise, the country is freed from epidemics. The risk of hunger and poverty is reduced. The country is able to create and provide jobs that boost its economic growth while gender equality is enhanced.
History of universal health care
The first steps to have a national health insurance system started in 1883 in Germany, when the industrial employers implemented the Sickness Insurance Law. The low-wage earners were provided illness and injury insurance through the collection of ”sick funds.” The funds were a combination of the employers’ contributions and the deductions from the wages of workers.
In 1911 the UK established the National Insurance Act, which provided primary care for daily wage earners. The Russian Empire followed in 1912. More countries followed the health insurance system. Japan implemented their own in 1927 and continued to improve it in 1935 and 1940.
In 1920 after the Russian Revolution, the Soviet Union created a centralized and public health care system although the rural residents were excluded from the system.
New Zealand established their own universal health care system from 1939 to 1941 in a series of steps while in the 1940s, Australia’s state of Queensland established a free hospital system for the public.
After the war
When World War II ended, many more countries around the world started to set up their own universal health care system. The UK set up the National Health Service in 1948. The Nordic countries of Sweden, Iceland, Norway, Denmark and Finland implemented their healthcare system from 1955 to 1964.
In 1961, Japan introduced universal health insurance to the nation. A gradual introduction of the system followed in the Canadian provinces from 1962 to 1972. Over at the Soviet Union, the rural residents were finally included in the system in 1969.
In 1975 Australia started with their Medibank system, which was replaced in 1984 with their own Medicare system. The Servizio Sanitario Nazionale was established in Italy in 1978.
Countries in Western and Southern Europe implemented their universal health coverage from the 1970s to the 2000s. France has initially instituted a national health insurance system in 1928 and continued to improve on it through the years until the entire population received coverage in the year 2000.
Some Asian countries like South Korea, Taiwan, Israel and Thailand introduced universal health coverage from 1989 to 2001.
After the 1900s, countries in the Asia-Pacific region, Africa, the Caribbean and Latin America followed. China, which has the world’s largest universal health care system, established theirs during this period. Progresses were also noted in nine countries, such as Vietnam, the Philippines, Indonesia, India, Kenya, Mali, Nigeria, Rwanda and Ghana.
Funding methods for universal health coverage
Each country that implements universal health care coverage has its own method of funding the initiative. Generally, the funds are primarily taken from tax collections, while some countries have additional levies from those collected from individual workers and their employers. Some people also opt to have optional or direct insurance through private payments, usually for health services that are not covered by the public health insurance system.
In most European countries, private and public contributions fund the health care coverage. In Sweden, Denmark, Spain and Portugal, the funds are sourced from taxes. Japan, France and Germany use a multi-payer system, where citizens use public and private health insurance.
Types of funding
Contributions to health care insurance are compulsory as stated by law. The type of funding differs, according to the mandate of each country’s government.
1. Compulsory insurance method
Through legislation, a country that imposes compulsory insurance requires all its residents to purchase insurance although there would be special cases where the insurance is provided by the government. In Canada, the fund comes from a single public source while in Germany, residents can choose from several public and private funds, although they provide the same standard service. The U.S. Patient Protection and Affordable Care Act and the system in Switzerland are based on this method.
2. Single payer method
In a single payer method, it is usually the government that pays for the costs of health care services. In this case, the single payer may enter into a contract with private organizations or establish its own. Here, the single payer refers to the funding mechanism. It is health care that is financed by one public entity that draws fund from a single source. It does not determine for whom the healthcare professionals work or the type of delivery of the services. In some forms of single payer method, a mix of public and private systems is used.
3. Tax-based method
In this method, various taxes are utilized in order for individuals to contribute to the financing of their health care services. In some countries, a pool is created, which will then be divided for the entire population. In other countries, the local governments raise and keep the taxes, reserving them for health care financing. Many countries, like Portugal, Spain, Italy, and the Nordic countries, New Zealand, Australia, Ireland, Canada and the United Kingdom draw health care funds solely from taxes.
Countries implementing insurance-based systems gather the funds to insure those with limited financial capacity through social security arrangements by sourcing funds from taxes either by paying for their insurance premiums or paying the medical bills directly.
4. Social health insurance method
This is a type of compulsory payment. Contributions are pooled from the government, enterprises, self-employed individuals and workers. The fund could either be a single or multiple fund. Social health insurance method, which is also called the “Bismarck Model,” is named after Chancellor Otto von Bismarck of Prussia. In the 19th century von Bismarck introduced the UHC system in Germany.
The fund manager contracts with public and private health insurance providers to provide a pre-determined health care package. Public and preventive health care may be provided by the Ministry of Health or the ministry can just manage the fund. Other services are provided by other non-governmental groups. This method is used in Japan, Israel, and most of Western Europe, and it is steadily gaining ground in Eastern Europe.
5. Private insurance method
In this funding method, families, individuals, associations and employers directly pay the health insurance premiums to insurance companies. These private health insurance policies are sold by community health insurers, and non-profit companies for profit companies. This type of insurance is often voluntary
In some countries that implement universal health coverage, private insurance typically excludes expensive health conditions and those services that can be provided by the state health care system.
In the U.S. for example, the government generally pays for the dialysis treatments of patients with end stage renal failure. Exceptions to this are those who have Medicare Advantage. For holders of privatized Medicare, their insurance company pays for their dialysis. However, a Medicare Advantage plan is not available to a person who already has end stage renal failure.
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We at Day Translations support the global endeavors of the World Health Organization and we want to encourage people from all over the world to do the same.