Universal Health Coverage in the EU: Are we really leaving no one behind?


Stella Kyriakides, European Commissioner for Health and Food Safety in Nicosia. Co-operators: Photographer: Iakovos Hatzistavrou European Union, 2020 Source: EC – Audiovisual Service.

This article was exclusively written for The European Sting by Ms. Mara Franke and Martina Steinmaurer, both medical students, representing “GandHI”, the global health project of the german medical student association. They are affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

Europe has always been a role model when talking about successful health insurance coverage. Germany and the United Kingdom are prime examples of how Universal Health Coverage [UHC] can transform society and economy. Theoretically, UHC has been implemented in all European countries(1). But how does theory relate to real life in this case?

We postulate that even in European health care systems, ranking among the health care systems with the highest per capita health care spending in the world (2), truly universal health coverage, reaching every single individual in society, has not been achieved. Many socially marginalized groups suffer from a lack of access to health care services and face a high burden of preventable diseases. Among those socially marginalized and excluded groups, homeless people face particularly substantial challenges in accessing health care: a lack of insurance and financial risk protection, a lack of knowledge and information on available health services as well as stigmatisation and prejudice when seeking care (3,4,5,6). UHC is usually funded by either tax revenues or a combination of public and private insurance and care delivery systems. Insurance for the very poor has to be covered by public funds. Therefore, emergency treatments can often be covered but follow-up or preventive care often remain unfunded. It is estimated that compared to the housed population, one year of homeless is associated with a loss of 0,117 QALYs, illustrating the substantial burden of disease and loss of well-being and health in the homeless population(7). Not surprisingly, this increases marginalization and inequality issues.

As a result of these factors, many homeless people suffer from easily preventable diseases, often of a dermatological or parasitical nature (8). According to a study conducted among the homeless population in Berlin in 2015, dermatological diseases were the most frequent health issue, affecting 35% of the study population (8).

Additionally, homeless people have a much higher rate of mental and psychiatric diseases compared to the average population (9) which hinder treatment seeking and adherence.

Especially in the care for NCDs long-term continuous therapy is crucial, even more so as NCDs such as hypertension and known risk factors such as smoking are more prevalent among the homeless than the general population (10).

The number of providers treating uninsured individuals and their reach is insufficient with respect to the population at need (8) and they face a severe lack of funding(10). Sufficient follow-up care, e.g. for wound management, especially after emergency treatment in A&E departments is almost nonexistent. This creates significant challenges down the road as wound infections and chronic wounds are some of the most prevalent diseases among homeless people(8).

Lastly, the stigma and outright discrimination homeless people experience when accessing health care can discourage further treatment seeking efforts and worsen health outcomes significantly.

With the homeless population and housing prices increasing drastically all over Europe (11), Europe’s current health care systems are neglecting the health care needs a substantial and growing part of the population they are supposed to be serving. Solutions must urgently be found to assure every single person can benefit from truly universal health coverage.


About the authors

Mara Franke and Martina Steinmaurer are both medical students, representing “GandHI”, the global health project of the german medical student association. Mara Franke is in her 9th semester, currently working on her doctorate thesis on socio- economic risk factors for malaria infection in Agogo, Ghana. he is interested in health system strengthening and social determinants of health. Martina Steinmaurer is in her final year of studies with interests in UHC and Global Surgery. With “GandHI” we are aiming to bring Global Health closer to medical students in Germany, as we advocate for global health education at medical universities, act as interest representatives and try to educate through a monthly newsletter (https://www.facebook.com/GandHIbvmd/).

the sting Milestones

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

COVID-19 outbreak: Commission supports repatriation of EU citizens from cruise ship in Japan

Youth Entrepreneurship Issue of the month: JEN, organisers of JADE October Meeting, on why JEs should come together

JADE Romania Celebrates the 4th Anniversary

He died so I could live: UN peacekeeper pays tribute to fallen colleague

EU Cohesion policy: first REACT-EU support measures for recovery and transition approved for the Netherlands and Austria

“Will TTIP solve the massive EU-US unemployment? Absolutely not!” A revealing Sting Exclusive with Tim Bennett from the Transatlantic Business Council

Inaction on obesity stands in the way of sustainable development

Ferry capsizes near Mosul, UN chief offers solidarity, support ‘as needed’

New Zealand will have a new ‘well-being budget,’ says Jacinda Ardern

‘The green economy is the future,’ UN chief says in Beijing, urging climate solutions that strengthen economies, protect the environment

New EU telecom rules: latest actions in time for transposition deadline

Arlington, USA: kick-off of the fifth round of the EU-US boxing match

Yemen: 11 more ‘terrible, senseless’ civilian deaths reported, following attack in Sana’a – top UN official

European Junior Enterprises to address the significant skills mismatch in the EU between school and employment

Which countries’ workers spend the longest (and shortest) in retirement?

Entrepreneurship in a newly shaped Europe: what is the survival kit for a young Catalan and British entrepreneur in 2018?

Conflict diamonds and climate change: Cooperate, don’t compete over natural resources urges Guterres

A fundamental transport transformation: Commission presents its plan for green, smart and affordable mobility

Ebola outbreak in DR Congo declared over, now let’s tackle other health challenges: WHO chief

Climate Change: A Healthcare Emergency

European Investment Bank to borrow €70 billion in 2013

How Costa Rica’s environment minister talks to his daughter about climate change

AI can be a game-changer for the world’s forests. Here’s how

The European Green Deal must be at the heart of the COVID-19 recovery

Approving most of EU’s accounts, EP requests new measures to protect EU spending

2014 will bring more European Union for the big guys and less for the weak

Palliative Care: the guarantee of a Human Right

Stronger partnerships with post-conflict countries needed to ensure ‘path towards durable peace’: UN chief

UN food relief agency airlifts aid to DR Congo province hit by Ebola outbreak

Why medical students decide to study abroad?

Viktor Orbán, Hungarian Prime Minister, at a 2015 event in Brussels, Berlaymont. (Copyright: European Union , 2015; Source: EC - Audiovisual Service; Photo: Lieven Creemers)

Hungary and Ireland build front to say no to EU tax harmonisation plan

UN Security Council offers Yemen Special Envoy ‘their full support’

WEF Davos 2016 LIVE: “CO2 is not the problem, it is the symptom”, the pilots who crossed the world using solar energy cry out from Davos

If the Current Situation in Hong Kong Arose in the West

Corruption In The Balkans Is Impeding EU Membership

Vaccination: understanding the challenges surrounding COVID-19 vaccination campaigns

Antarctica: the final coronavirus-free frontier. But will it stay that way?

How the EU’s new data-sharing strategy could benefit companies

Doing the right thing at the worst time: this is why protecting human rights protects businesses

Leveraging digital for high quality internships

What we take for granted: The EU is not perfect

On sidelines of UN climate summit, US President calls for protection of religious freedom

Closing the loop: Commission delivers on Circular Economy Action Plan

A letter from Italy: Our insecurity in COVID-19 times

More than half of world’s refugee children ‘do not get an education’, warns UNHCR

European Commission and European Investment Fund launch €75 million BlueInvest Fund

What could a no-deal Brexit mean for developing countries?

EU summit: Are the London Tories planning an exit from the EU?

What’s everyone talking about at Davos 2020?

Why digital inclusion must be at the centre of resetting education in Africa

Faith can overcome religious nationalism. Here’s how

Sanity in times of COVID-19

Female directors reached record highs in 2019 Hollywood

EU-US resume trade negotiations under the spell of NSA surveillance

International community urged to deliver on promise for better future for Bosnia and Herzegovina

“Health and environment first of all”, EU says with forced optimism after 7th round of TTIP talks

Independent UN rights expert calls for compassion, not sanctions on Venezuela

1 in 7 people would choose not to fly because of climate change

Baking The Galette-des-rois Of Egalitarianism

The winds of change: 5 charts on the future of offshore power

More Stings?


Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s