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Making Fair Choices on the Path to Universal Health Coverage : Applying Principles to Difficult Cases (Inglês)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. Inthis journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles formaking such decisions put forward by the WHO Consultative Group on Equity and UHC.These principles include maximizing population health, priority for the worse off, andshielding people from health-related financial risks. But how should one apply theseprinciples in particular cases and how should one adjudicate between them when theirdemands conflict? This paper by some members of the Consultative Group and a diversegroup of health policy professionals addresses these questions. It considers three stylizedversions of actual policy dilemmas. Each of these cases pertains to one of the three principaldimensions of progress towards UHC: which services to cover first, which populations toprioritize for coverage, and how to move from out-of-pocket expenditures to pre-paymentwith pooling of funds. Our cases are simplified to highlight common trade-offs. While wemake specific recommendations, our primary aim is to demonstrate both the form andsubstance of the reasoning involved in striking a fair balance between competing interestson the road to UHC.


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    Making Fair Choices on the Path to Universal Health Coverage : Applying Principles to Difficult Cases

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    financial risk protection;formal sector;gross domestic product;informal sector;social health insurance;catastrophic expenditure;Norwegian Agency for Development;mandatory enrollment;global burden of disease;access to health service;School of Public Health;formal sector worker;health problem;catastrophic health expenditure;diabetes;universal coverage;renal disease;health gain;private health care;health insurance scheme;informal sector worker;pool of fund;health outcome;discount rate;ill health;population health;risk profile;global public health;cost-effectiveness of interventions;health insurance coverage;high poverty rate;measures of population;expansion of coverage;safety net program;access to care;health insurance reforms;loss of income;cost of access;comprehensive health insurance;Universal Health Care;coronary heart disease;center for health;people with disability;families with income;public health care;private health insurance;shock to income;health care cost;cost of travel;



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