Universal Health Coverage - National Policies

“Universal health coverage means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation and palliative care.

“Every country has a different path to achieving UHC and deciding what to cover based on the needs of their people and the resources at hand. However the importance of access to health services and information as a basic human right is universal.

“To make health for all a reality, all people must have access to high quality services for their health and the health of their families and communities. To do so, skilled health workers providing quality, people-centred care; and policy-makers committed to investing in universal health coverage are essential.

“Universal health coverage requires strong, people-centred primary health care. Good health systems are rooted in the communities they serve. They focus not only on preventing and treating disease and illness, but also on helping to improve well-being and quality of life.”

Source: World Health Organization. Universal Health Coverage: Overview. Last accessed June 4, 2023.

“More recent economic work suggests a more nuanced account of insurance. In a range of clinical situations, Baicker, Mullainnathan, and Schwartzstein note that patients seem to forgo highly efficient healthcare. [15] Even when healthcare is deeply subsidized or free, some diabetics do not adhere to their insulin regimens and some patients with heart disease do not take their beta blockers, for examples. The authors suggest that in these special situations where individuals may be biased against consumption, optimal copays should sometimes be zero, or perhaps negative. They coin a term, ‘negative behavioral hazard,’ to describe the tendency of individuals to under-consume valuable health care interventions, in contrast to ‘positive behavioral hazard,’ which is the tendency of individuals to over-consume interventions lacking value.

“In this same vein, Brot-Goldberg and associates recently studied a change to greater cost-sharing exposure among a group of highly-paid employees, and found that, while it reduced spending, the intervention did not cause greater price-shopping. [16] In other work, high-deductible healthcare plans have been shown to reduce health spending, but also reduce appropriate preventative care and medication adherence. [17] Recent research suggests that providers may drive spending choices to a much greater degree than patients. [18,19]”

Source: Robertson CT, Yuan A, Zhang W, Joiner K. (2020). Distinguishing moral hazard from access for high-cost healthcare under insurance. PLoS ONE 15(4): e0231768. doi.org/10.1371/journal.pone.0231768.

“We were consistently unable to find a significant effect of moral hazard waste, and the upper ranges of our confidence intervals help rule out the hypothesis that the problem is substantial in the experimental sample. In contrast, we consistently found a substantial effect of insurance to provide access to expensive healthcare. These suggest that moral hazard in the healthcare sector may not be large, but the benefit of insurance providing access to expensive healthcare could be substantial.

“This research project sheds light on moral hazard, which has preoccupied health economics and U.S. health policy for half a century. By testing a novel counterfactual of indemnity insurance, we distinguished the access function of health insurance from waste, and thus informed longstanding debates about how fulsome health insurance coverage should be.

“Importantly, we focus on expensive interventions, associated with serious illness, which drives aggregate health spending. [21] Our data suggest that in these circumstances, moral hazard waste is not substantial, since the vast majority of spending stimulated by insurance would happen with fungible insurance, which preserves a price signal for consumers. We make no claim that these findings can or should be extrapolated directly to more routine care decisions.

“Healthcare is far from an ideal market: it is rife with wasteful spending and infected by all sorts of market failures, including the misaligned incentives of healthcare providers. Our data show what we know obtains in the real world: healthcare consumers are often willing to consume low-value care, when their physicians recommend it. Yet, our data show that the problem exists regardless of whether patients have a traditional insurance policy that occludes the price of care or an indemnity policy that makes the price salient along with the opportunity costs of consumption. Thus, our data helps to pinpoint the problem, and helps us understand where future policymaking should focus. For example, our study suggests that it will be more effective to align incentives of providers with health and thrift, rather than placing more risk on patients.”

Universal Health Coverage - National Policies - US Health System - World Health Systems Facts

World Health Systems Facts is a project of the Real Reporting Foundation. We provide reliable statistics and other data from authoritative sources regarding health systems and policies in the US and sixteen other nations.

Page last updated March 28, 2025 by Doug McVay, Editor.