Evidence suggests that progress towards universal health coverage generally results in substantial improvements to population health.

Evidence suggests that progress towards universal health coverage generally results in substantial improvements to population health, according to a new paper from researchers at Imperial College London.

The issues surrounding universal health coverage - how an adequate standard of healthcare can be provided to all people, while ensuring that use of health services does not expose people to financial hardship - have never been more controversial or politically relevant than now. Dr Rodrigo Moreno-Serra and Professor Peter Smith, of Imperial College Business School and the Centre for Health Policy, provided a comprehensive assessment of the current evidence for the effects of universal coverage on people's health in the first of a series of papers on universal health coverage published in The Lancet.

They found that the evidence available suggests that broader health coverage leads to better access to necessary care and improved population health, particularly for the poorest people. Countries that rely on out-of-pocket payments to finance their health systems are often in a worse position to guarantee access to care and protect their citizens from the financial risks of illness, which tends to be damaging to people's health. In these situations most of the cost of treatment by doctors, pharmacists and hospitals, for example, has to be met by the individual when they fall sick. Even when people have insurance coverage, patients still may have to pay as a result of restricted policies.

Dr Rodrigo Moreno-Serra, the paper's lead author, says: "Progress towards universal health coverage may be at risk in the current financial climate, and if financial pressures result in universal health coverage being neglected in some countries, this is likely to have an adverse effect on people's health and their broader welfare. For example, in Greece and Spain the global economic downturn has led to an increase in user payments for health services."

Globally, paying for medical expenses out of pocket is still the dominant method of meeting health care costs, and WHO estimates published in 2010 suggest that more than a billion people cannot use the health services they need, either because they are not available, or because they cannot afford to use them. The special collection of papers published in The Lancet explores the social, political, and economic issues around universal health care, addressing the evidence base for the effects of universal health coverage on population health, government involvement in universal healthcare, and how low-income and middle-income countries in Africa and Asia are making the transition to universal health coverage.

Lancet article: Does progress towards universal health coverage improve population health?

The Lancet Series on Universal Health Coverage