Giving Compass' Take:
- Tra Tran and her team identify three key lessons that can be learned from China and Vietnam's distinct approaches to the pursuit of universal health coverage.
- Why are healthcare costs per capita higher in the United States than any other country? How can you support policy change that increases healthcare access and reduces costs for all Americans?
- Read about healthcare reform options in the United States.
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If it was not clear before COVID-19, it is obvious now that achieving the United Nations 2030 Sustainable Development Goals and the World Health Organization’s Triple Billion Goals will be impossible without universal health coverage (UHC). UHC is measured by the World Health Organization (WHO) along three dimensions: population coverage (who’s covered); service coverage (which services are covered); and financial coverage (what proportion of health service expenses are covered). With limited resources, many trade-offs must be made among these three dimensions. According to a 2017 report by the WHO and World Bank, the past decade’s increase in service coverage is disastrously paralleled with an increase in catastrophic spending. This situation forces people to choose between physical health or financial ruin, a terrible yet common decision many must make.
While there is no one-size-fits-all path to UHC, a recent study on China and Vietnam may shed light on this dilemma. Both countries have made impressive progress toward UHC in the past decade while prioritizing different dimensions. China’s prioritization of population coverage helped it achieve the largest population coverage in history in a relatively short period of time. Meanwhile, Vietnam provided a generous benefit package that is more equitable for all.
Both have made sizeable gains in population health, and other countries could learn from their struggles and successes. Our study points to three lessons.
- A commitment to fund national health insurance programs is the sine qua non for universal coverage
lesson. - While population coverage is the foundation of UHC, financial risk protection and healthy populations are the real goals.
- How much a society values equity determines the path it takes to UHC.
Though the future is uncertain, both China’s and Vietnam’s prospects look promising as they continue to customize their designs to their realities.
Read the full article about universal healthcare by Tra Tran, Shenglan Tang, and Wenhui Mao at Brookings.