(1) Canada and the UK have free universal health care and fairly extensive welfare programs to support their populations. Yet, since the introduction of universal health care, the gaps in health and life expectancy between richer and poorer people have grown larger. How is that possible? (2) Preventive medicine (e.g., screening, early diagnosis, and putting people on medication to modify risk factors) is not making much progress in creating a healthier society. Why is this the case? (3) Why might the distribution of resources within a society have a decisive impact on its health?
Ans) 1) UHC as a means to achieve greater equity in health and financial risk protection.
- Universal health coverage (UHC) is essentially about basing access to health services on need rather than on ability to pay or other socio-cultural attributes.
- The term ‘coverage’ is used to denote access that is realised, going beyond legislative entitlement to effective coverage.
- It also includes the quality of health
services received (preventive, promotive, curative, rehabilitative
and palliative), social equity, and the financial risk protection
that has been obtained.
- It is a political concept as it goes to the heart of the entitlements that a citizen can expect from the state.
- UHC is far from a new concept, and was recently described as “old wine in a new bottle”.
Following World War II, the principles embodied in UHC emerged from deliberate efforts to foster social,
- Defined as “the proportion of the population in need of an
intervention who have received an effective intervention”,
witheffective services defined as the minimum amount of inputs
and
processes required “to produce desired health effects”.
cohesion in Europe and human security, in Japan.
UHC is firmly rooted in the right to health, which
was enshrined in the Constitution of WHO in 1946, and included in
the Universal Declaration of Human
Rights two years later.
- The right to health re-emerged in 1978 at the heart of the
Alma Ata Declaration on
Primary Healthcare.
- Every country has now signed up to at least one treaty that acknowledges the right to health and many countries’ constitutions echo this entitlement.
- Thenew focus on UHC has
allowed countries to act on and operationalise existing
constitutional guarantees of equitable access or the right to
health and health services.
- Growing global and country-level momentum on UHC
- It offers huge potential for realisation of the right to health
for those most in need if efforts to achieve.
- UHC prioritise the needs of those who are poorest and most
vulnerable.vii
Ans) 2) Preventive health behaviors: These are actions that healthy people undertake to keep themselves or others healthy and prevent disease or detect illness when there are no symptoms.
- Examples include handwashing with soap, using insecticide treated mosquito nets and exclusive breastfeeding to age six months.
- Preventive care is important because it helps you stay healthy and access prompt treatment when necessary, and it can also help reduce your overall medical expenses.
- Stay healthier and get more effective treatment – Many types of screenings and tests can catch a disease before it starts.
- Background risk factors, such as age, sex, level of education and genetic composition; Behavioural risk factors, such as tobacco use, unhealthy diet and physical inactivity; and Intermediate risk factors, such as elevated blood lipids, diabetes, high blood pressure and overweight/obesity.
- Most Americans miss out on preventive healthcare. “Some of the commonly known reasons for not getting the recommended preventive services include:
Ans) 3) when distributing scarce health resources, there is a reason to prefer persons who are not responsible, or less responsible, for their predicament to persons who are, or are more, responsible. The PFR reflects a choice-based conception of responsibility, according to which a person is responsible for the existence of a conflict if he chooses to take a risk that might lead to such a conflict, as opposed to a causal conception of responsibility. The relevant responsibility could take various forms, including unhealthy indulgences such as smoking, alcoholism or overeating, or especially dangerous activities such as mountain climbing.
The question whether, or to what extent, persons are responsible in the relevant sense for behaviors such as smoking or alcoholism and for their effects on health, particularly those that might create a conflict between them and others for health resources, is complex and controversial.
- The PFR reflects a conception of fairness—a reason for action that is intrinsically important in the adjudication of interpersonal conflicts.
(1) Canada and the UK have free universal health care and fairly extensive welfare programs to...