Obamacare everywhere: U.N. votes in favor of universal health coverage

December 12, 2012

The United Nations General Assembly voted in favor of a draft resolution supporting universal health coverage, signaling the importance of universal healthcare to the international development agenda.

The resolution, which is backed by the United States, encourages governments to come up with systems that avoid direct payments at the point of delivery, include a way to prepay for financial contributions toward health care and a mechanism to pool risks among the population in order to avoid catastrophic expenses. Essentially, this amounts to a system where health insurance is either attainable and affordable for all, or the federal government picks up the tab for health care costs.

The U.N. also urged governments to "promote the inclusion of universal health coverage in the implementation of the internationally agreed development goals...as a means of promoting sustained, inclusive and equitable growth, social cohesion and well-being of the population."

Universal healthcare is widely seen as a hallmark of a developed nation, with nearly all high- and many middle-income countries having some form of universal coverage in place.

Here's a map my colleague Max Fisher once made depicting all the countries in the world that have universal healthcare coverage (in green); it also very nearly delineates the developed countries from the developing ones.


Wikimedia/Max Fisher

Health experts say 40 percent of the world's population – about 2.8 billion people – have some form of risk-pooled health insurance. Opinions vary as to whether the United States' Affordable Care Act actually counts as universal health care (this map excludes the United States, for example), but others say its mandate provision means it comes close enough.

Over the past few years, rich and poor countries alike have been moving toward universal coverage.

Following the WHO's 2010 report, Health systems financing: the path to universal coverage, more than 60 middle- and low-income countries requested technical assistance and advice to implement universal health coverage.

Countries that were once considered universal-health “blind spots,” such as India and South Africa, are developing systems that provide access to medical care for nearly all of their citizens.

China, for example, is now attempting to reconcile its patchwork of health plans and it’s close to completing a $124 billion project that aims to insure 90 percent of the nation’s residents. In India, a system started in 2008 has provided hospital access to 100 million people who live below the poverty line.

Of course, U.N. resolutions are generally non-binding, so the resolution may not lead to meaningful change in the member nations or elsewhere. (There have been multiple resolutions calling for a moratorium on the death penalty, for example). But the U.N. has been pressured for a declaration on universal health care before and it does show an interesting consensus among countries about the importance of health access to broader development goals.

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Olga Khazan | December 12, 2012