In Chile, where free-market measures eroded the country’s universal health system in the 1980s, a Socialist candidate won the presidency in 2000 for the first time in nearly 30 years on a promise to renew guaranteed health care.
The Thai system, set up a decade ago, has survived years of political upheaval and a military coup. “No party dares touch it,” said Suwit Wibulpolprasert, a senior adviser to the Ministry of Public Health.
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“We must define the nature and scope of this struggle, or else it will define us,” the president said.
Many political leaders around the world also have concluded that creating a system of universal health care is crucial to remaining competitive globally and sustaining economic growth.
Chinese leaders were concerned that their citizens were saving excessively because there was no system to protect them if they got seriously ill, said Yanzhong Huang, director of the Center for Global Health Studies at Seton Hall University. The high savings rate was restraining domestic demand for consumer items, making the economy overly dependent on selling goods abroad.
In Mexico, political leaders were concerned that poor families were often forced to pull a child out of school or give up productive assets such as livestock or equipment to pay medical bills, said Frenk, the former health minister.
Before embarking on its health-care push, the Mexican government found that 4 million people every year were being driven into bankruptcy by illness. “That was a huge drag on the economy,” Frenk said.
Today, Mexico’s new government insurance plan — known as Seguro Popular — covers more than 50 million people, filling the gap left by the traditional health insurance system funded by payroll taxes.
Such steps don’t eliminate all financial strain on households. Indeed, in many poor nations that are expanding health-care coverage, such as Vietnam and the Philippines, people still must pay most of their own medical bills, a sign of skimpy coverage.
Governments, too, feel the strain. Colombia’s universal health-care system, set up in 1993, has cost more than twice what was expected, said Ramiro Guerrero, a former vice minister of health.
Even so, there is growing evidence that universal coverage is protecting millions of people worldwide from financial ruin.
In Rwanda, researchers found that citizens who had joined one of the nation’s health plans were nearly 75 percent less likely to be hit with a catastrophic health-care bill that threatened to bankrupt them.
And although the effect of broader coverage on overall health is still unclear, there are some signs that citizens of countries that are committed to guaranteeing health coverage are getting more treatment for serious illnesses.
— Tribune
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