Health Financing Strategies To Achieve Universal Health Coverage

Universal health coverage (UHC) is defined as ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. UHC embodies equity in access to health services-those who need the service should get them, not only those who can pay for them; financial risk protection-ensuring that the cause of using care does not put people at risk of financial hardship and finally that the quality of health services should be good enough to improve the health of those receiving services. This text, however looks at the ways health financing strategies can be adopted to achieve universal coverage. In considering financing options, stakeholders need to consider; raising enough money for health services, pooling funds to improve financial risk protection and aid financing in order to improve the performance of the overall health systems.

RAISING ENOUGH MONEY FOR HEALTH SERVICES; how much resources should be allocated for health? But if UHC is the goal, then Ghana needs to move towards predominant reliance on public funding for health systems, as well as an organization of systems that serves the entire population rather than catering to privileged groups. Addressing the ever-increasing demands for service coverage is a major political and technical challenge, because both medical technology and the demand for health services are constantly increasing. This is driven by rising expectations from people who want to live longer and healthier lives, and the technological advances that make more services and interventions available.

Indeed, evidence suggests that as countries develop, the relative demand for health services by the population compared to other goods and services increases, so the proportion of a country’s gross domestic product (GDP) spend on health actually increases too. We should spend a growing proportion of national wealth on health as we are developing in order to reflect popular demand. Broadly speaking, the volume and quality of services the population needs is captured by our national demographics, the burden of disease, people’s expectations for the quality of services they should receive, and the of governments, firms and individuals to provide resources for the system. Because of variability, there is no definitive figure for the cost of providing “full” population coverage. This reflects the fact that we should be willing to spend a higher proportion of incomes to improve or maintain health as we are developing. Regardless of the precise mix of sources from which the health system is financed, it is public spending that plays a key role. In general, the more money that governments spend on health, the less need for people to search for funds to obtain the services that they need.

POOLING FUNDS TO IMPROVE FINANCIAL RISK PROTECTION; Financial risk protection is a key component of universal health coverage, which is defined as access to all needed quality health services without financial hardship. The assurance that people will not suffer financial hardship in using services which is an integral component of UHC, is a recognition that health system should not only improve health but this improvement should not be done in ways that are detrimental to non-health aspects of well-being. The means used to pay for health services, taxes, government charges of various sorts, insurance and out-of-pocket payment at the time of service use are voluntary to the extent that people choose whether or not

to pay or to use services. These mechanisms can be channel in a form that involves the pooling of financial resources.

As the name suggests, pooling involves the accumulation of prepaid contributions from individuals into an overall pool or fund which is then used to pay for services for all the members of the pool according to need. This can be funding specified for health e.g. a health insurance pool or general government revenues some of which is used to finance health. Pooling will therefore in this way reduces or eliminates the financial risks associated with ill-health.

.AID FINANCING; Even if efforts are raised to increase domestic funding for health and if they are pooled more efficiently, the sums raised will not be sufficient to finance services of adequate quantity and quality to the entire population. This means that external aid financing will be needed to augment domestic funds at least in the medium term. For aid financing to be useful in helping countries move towards UHC, it too should meet the UHC criteria of effectiveness, efficiency and equity. This is more likely to be achieved when aid financing is used to augment domestic pooled resources rather than financing fragmented vertical projects. In addition to increase the overall level of funds available to provide health care, we can also rely on external aid to plan and implement appropriate health financing strategies or strategies designed to strengthen human resources for health or information systems, and it should be vital that donor initiatives and projects are consistent with the equity principles that should be the foundation of any UHC strategy.

Finally, an understanding of the reasons for pursuing UHC include all-important human rights aspects of universal health coverage, and the health financing imperatives that underpin workable approaches is the foundation of effective UHC advocacy. To make progress towards universal health coverage, there should be increase in the share of prepaid revenues in the health system, and minimize fragmentation in risk-sharing mechanisms.

EMMANUEL ANNAN
PHYSICIAN ASSISTANT STUDENT
UNIVERSITY OF CAPE COAST
LEVEL 200
[email protected]