Addressing the Global Health Crisis: Universal Health Protection Policies 1
1. Introduction
Health protection coverage is crucial for every human being and to the economy as a whole since labour productivity requires a healthy workforce and employment effects of
the health sector significantly contribute to overall employment in most countries. In fact, good health is a prerequisite for sustainable development, economic
growth and equity: A labour force can only be fully productive if based on all people at working age that are not deprived by sickness, disability or low life expectancy. It is also
important that all people at working age are in a position to generate income from work. Given this relationship, the economic returns on investing in health are estimated at 24 per
cent of economic growth in developing countries between 2000 and 2011 taking into account increases in both national income and life years gained The Lancet Commission,
2013.
Access to health protection is thus a key for both good health of the population and for boosting the economy. Ensuring that everyone can attend quality health care is a
prerequisite for sustainable development based on equity and inclusiveness. To effectively address the global health protection crisis, universality of health coverage must involve
equal access to needed health care for all people wherever they live and work, in rural or urban areas, in the formal or informal economy, no matter if one is poor or wealthy,
women or men, elderly or children.
However, equitable health coverage does not occur automatically even if wealth increases. It requires inclusive policies addressing inequities resulting from access barriers
both within and beyond the health sector: Within the health sector, often inequities in access to health care occur in the absence of legislation that affiliates the people to a health
scheme or system, by services that are of low quality or not affordable due to high out-of- pocket payments OOP, or just not available due to the absence of health workers to
deliver needed care. It is also important to address issues beyond the health sector that induce access inequities to health care such as poverty.
Removing the root causes behind these developments involves in-depth analyses and the development of a set of comprehensive policies such as closing coverage gaps in
legislation, developing fair health financing mechanisms and ensuring the availability of health services even in remote areas. Revealing the economic potential of universal health
coverage also requires shaping inclusive labour market and developmental policies alleviating poverty, as unemployment and lack of income range high among the barriers to
access needed health care given the need to pay for health care. Only such comprehensive policies have the potential to recover investments in health care at the national level and
yield returns of investments through higher productivity and employment.
In the following we are assessing the dimensions and extent of the global health protection crisis and thus missed opportunities for sustainable development based on
equally shared benefits. Further we suggest policy responses to address the crisis. We will use the framework of the Social Protection Floor approach as outlined in ILO
Recommendation 202 concerning National Floors of Social Protection 2012. It stipulates that all residents and children in a given country should be guaranteed by legislation at
least essential health care, prevention and maternal care. Universality thereby implies rights-based approaches that are implemented with a view to provide access to available
care of acceptable quality. In addition, it is necessary that co-payments, user fees and other costs involved are affordable and that financial protection is provided in order to avoid
hardship or impoverishment. Finally, effective access requires good governance of schemes and systems, which should be based on accountability, including participatory
processes such as social and national dialogue.
2 Addressing the Global Health Crisis: Universal Health Protection Policies
2. The dimensions of the global health crisis
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