This paper raises critical questions around the wide and growing enthusiasm for Universal Health Coverage (UHC), which is increasingly seen as a silver-bullet solution to health care needs in low- and middle-income countries. Global health agencies and financial institutions typically define it as a health financing system based on pooling of funds to provide health coverage for a country’s entire population, often in the form of a ‘basic package’ of services made available through health insurance and provided by a growing private sector.
Although these programs are now zealously promoted by global health agencies, the evidence to support their implementation remains extremely thin. The paper argues that secure finances for health care are a necessary but insufficient condition for systems that are equitable and provide good quality care. Re-imagining public health care – rather than the private sellout of health systems via UHC – is argued to be the only way forward in building truly universal health outcomes.
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Occasional Paper No. 20
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