The Goals and Challenges of Achieving UHC: an economist’s view William C. Hsiao UC in Developing-Country Health Systems: Ethical Dilemmas April 18, 2013

Universal Coverage

Universal coverage is an effective strategy to achieve noble goals and has three dimensions. However, it require priority setting when resources are limited. BreadthWho is covered? Scope What services are covered? Depth What is the level of coverage?

Financing Money is the Mother’s Milk of Health Care

Financing is More Than Mobilize Money Mobilize & collect Funds Allocate Resources Pool the Risk Payment

Issues in Financing What’s the nation’s ethical foundation for health care? Is equity a priority over efficiency? For whom and for what services/drugs? How much would the program cost? Can the nation afford it? Who pays? Can the society transform money into effective and efficient services? Is financing scheme sustainable?

Effective Coverage Insurance coverage ≠ Effective coverage

Typical Current Situation—Low Income Nations Depth (Share of cost from pooled sources) Breadth (Proportion of people covered by income level) Scope (Service Covered) Top 20% Next 30% Bottom 50% Income Class:

Priority: Pro-Poor Depth (Share of cost from pooled sources) Breadth (Proportion of people covered by income level) Scope (Service Covered) Top 20% Next 30% Bottom 50% Income Class:

Priority: Pro-poor Depth (Share of cost from pooled sources) Breadth (Proportion of people covered by income level) Scope (Service Covered) Top 20% Next 30% Bottom 50% Income Class:

Priority: Satisfy the Affluent People Depth (Share of cost from pooled sources) Breadth (Proportion of people covered by income level) Scope (Service Covered) Top 20% Next 30% Bottom 50% Income Class:

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