Delivering health care for all

Governments need to extend social health protection to all, including workers in all forms of employment. While progressively expanding coverage, priority should be given to lower income groups, enabling access through subsidies. This means risk can be pooled, while respecting the principles of solidarity and equity. Crucially, universal coverage limits discrimination against the poor at the point of care. 

In the drive to extend health care coverage, the focus must be on primary and preventive care, not just curative health protection. Strengthening primary health care and community services has been the entry point for many countries that have made good progress towards universal health care. Such expansion requires an increase in health facilities and human resources. Mobile outreach from fixed health care sites, digital technologies and national campaigns can rapidly deliver health services to a substantial portion of people previously left behind. 

Access to universal health care coverage can be attained through extending social health protection to all. Social health protection ensures access to quality services and guarantees income security by compensating for loss of income in case of sickness. Health care benefits for the workforce should be integrated within comprehensive social protection systems. This leaves informal workers less exposed and vulnerable. Health care protection should be extended to the household rather than the individual to ensure broader coverage and include children, women and older persons. 

Evolving needs and expectations must be anticipated as health care systems are redesigned. As life expectancy increases, providing public institutional care along with ageing-in-place arrangements for long-term care of older persons, chronically ill persons and persons with disabilities must be included in health care expansion strategies. Expanding good quality health services under universal health care and social health protection will require more than 40 million jobs to be created by 2030.