Is Universal Health Coverage really available for all in the European Union?

kyriakides_

Ms. Stella Kyriakides, EU Commissioner responsible for Health (Co-operators: Photographer: Elyxandro Cegarra European Union, 2020 Source: EC – Audiovisual Service)

This article was exclusively written for The European Sting by Ms. Nweke Ozioma Ruth, a Nigerian medical student, a member of Standing Committee on Sexual reproductive Health, HIV/AIDS and Gender Based violence[SCORA]; an organization under Nigerian Medical Students Association which is aimed at providing awareness on issues concerning sexual reproductive health and HIV/AIDS. She is 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 writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.


Several million people in the WHO European Region are impoverished and even more face financial hardship as a result of illness because they have to pay out-of-pocket for health care. These high levels of out-of-pocket payments undermine protection against the financial risk of ill-health and increase social inequalities. Universal health coverage involves extending coverage of health services to the whole population, expanding the range of effective services and reducing user charges

What is universal health coverage? According to WHO,

Universal health coverage (UHC) ensures that all people are able to access effective,  good-quality health services when they need them, without experiencing financial hardship. It reflects the values and principles underpinning health systems in Europe – universality, access to good-quality care, equity and solidarity.

Most countries in the WHO European Region offer universal population coverage,  but many people still have to pay out-of-pocket for needed health services. These Out-of-pocket payments are more likely to be catastrophic or impoverishing where levels of public spending on health are low. Medicines being usually the largest driver of high out-of-pocket payments. Sadly, Poorer people and those with chronic conditions are particularly likely to face  financial barriers to accessing health care. This widens the health divide within  and across countries.

The economic crisis has challenged UHC. Since the crisis began, some countries  have seen an increase in unmet needs for health care due to cost and an increase in the incidence of catastrophic or impoverishing out-of-pocket payments. Recent measures taken by the Spanish Government have broken the country’s universal health coverage. Spanish health policy is thus going in the opposite direction to recommendations from the WHO Commission on Social Determinants of Health (CSDH) and in your Series on universal health coverage.

These measures represent an unwelcome move towards a system with different access and availability for different population groups. People who do not contribute to social security will not have access to health care unless they can demonstrate an income level below the poverty line or pay for services. Regional differences could also open up as the regional governments of some Autonomous Communities plan to implement palliative measures by giving provisional access to these population groups.

The WHO CSDH recommended reducing inequities by ensuring a good start in life, and having measures to support employment and good working environments. Instead, the Spanish Government has cut the budgets for sanitation and the public education system and has reduced benefits to families of lower socioeconomic status. Unemployment affects one in two people younger than 45 years, including most of the main family wage earners.

It would be easy to predict that the health of Spain’s next generation will be worse than that of the current one and that the health gap will increase unless governments, politicians, and civil society reverse the current trends on health and social policy. It is safe to say that there are people who are left behind in the Universal Health Coverage in Europe.

References

1.Lancet.com; Universal Health Coverage in Europe.

2.WHO; Universal Health Coverage.

About the author

Nweke Ozioma Ruth is a Nigerian medical student, a member of Standing Committee on Sexual reproductive Health, HIV/AIDS and Gender Based violence[SCORA]; an organization under Nigerian Medical Students Association which is aimed at providing awareness on issues concerning sexual reproductive health and HIV/AIDS. She is also a member of Live Mother and Child Initiative which is aimed at providing sexual and reproductive health and right related services to women in rural areas of eastern Nigeria. She has over one year experience working and volunteering with organizations and initiatives promoting sexual and reproductive health and right, comprehensive sexual education and Gender based violence advocacy.

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