Expanding Health Service Coverage for Health Without Financial Hardship

Keeping ourselves healthy is exceptionally crucial, yet it is not easy. The development of healthcare systems has enabled people to live longer than before. However, today’s polycrisis has brought new threats. For some, these threats entail greater financial hardship.

Multiple Health Challenges

People are grappling with complex public health issues. Non-communicable diseases are still the leading cause of death globally, costing the lives of 43 million people in 2021.

Furthermore, lack of communal spaces and infrastructures forces people to spend more time indoors, leading to a sedentary lifestyle, minimal social connections, and poor mental wellbeing. When they do go outside, they are exposed to high levels of air pollution, which causes respiratory problems and other health issues.

Some feel it more than others. The World Health Organization states that 73% of non-communicable disease deaths occur in low- and middle-income countries. Meanwhile, a study shows that 80% of people exposed to high levels of air pollution live in these countries, where economies still depend on high-emission industries and technologies.

UHC and Financial Hardship

This condition highlights the inequality in healthcare access and outcomes. Health systems should allow people who need treatment to get it without pushing them into, or further into, poverty due to significant health spending. Universal healthcare coverage (UHC) aims to address this issue.

A joint report by the WHO and the World Bank finds progress in global UHC service coverage, rising from 54 to 71 points on the Service Coverage Index. The increase is primarily attributed to improvements in infectious disease treatment.

The report also notes a decline in the number of people experiencing financial hardship due to large out-of-pocket (OOP) health payments, going from 34% to 26% between 2000 and 2022. OOP health payments occur when patients have to pay for expenses that are not covered by public or private insurance.

However, this decline is largely driven by the global decline in poverty rate. This means that there are fewer people at risk of financial hardship due to health expenses because of their own financial stability, rather than because of UHC expansion. In contrast, the share of people living in poverty who have to make OOP health payments increased from 64% to 76% since 2000. People living in poverty remain vulnerable to multiple health threats, and still have to bear the cost of unaffordable healthcare.

Expanding Coverage

Gaps above underscore the urgent need to accelerate UHC expansion to reach people who need it the most. One critical bottom line is to ensure that free essential healthcare services are accessible to people living in poverty. Additionally, strengthening primary healthcare, including prevention, early detection, and treatment services, can reduce barriers and ensure continuity of treatments.

All of these will require substantial public funds to expand service coverage. To achieve this, strong political commitment from government officials is more important than ever; it is the fundamental basis for taking bold actions to realize inclusive, accessible, and universal health services for all without the looming threat of financial hardship.

Editor: Nazalea Kusuma