Half of the world’s population lacks access to essential health services. Each year, around 100 million are pushed into poverty due to having to pay for necessary healthcare out of their own pockets.
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While access to healthcare across the globe has improved since 1990, inequalities in access to healthcare have grown. This inequitable access has resulted in some populations receiving less care than meets their needs or care that is sub-optimal to that received by other groups. Inequalities in access to healthcare lead to worse healthcare outcomes in some groups.
Global healthcare inequalities must be addressed to ensure that everyone receives a sufficient level of quality care. Everyone has the right to access healthcare. Inequalities must be addressed as a matter of urgency to improve healthcare outcomes across the world. Here, we discuss the current state of global healthcare inequalities and how they may be solved.
Millions die each year due to lack of access to healthcare
According to recent figures presented in a report by the World Bank and the World Health Organization (WHO), around 800 million people are spending at least 10% of their household incomes on healthcare for themselves or a family member. For around 100 million people, these out-of-pocket expenses are pushing them into extreme poverty, as a result, they are forced to live on $1.90 a day or less.
It is completely unacceptable that for some people, the cost of healthcare is pushing them into poverty. Everyone deserves the right to access healthcare regardless of where they live or what their income may be. In the US alone, it is estimated that over 26,000 people die each year due to a lack of health insurance. Across the world, it is estimated that 5.7 million people in low and middle-income countries die each year from poor quality healthcare, and 2.9 million people die from being unable to access care.
To address this inequality that is causing millions to die unnecessarily each year, countries across the globe must establish universal health coverage (UHC).
Achieving Universal Health Coverage
UHC is a solution whereby every person would obtain access to the health services they need, when they need them, without facing healthcare costs that force them into financial hardship.
The United Nations (UN) have included achieving UHC as one of their sustainable development goals that each nation must work toward. This target was set in 2015 and reaffirmed at the United Nations General Assembly High-Level Meeting on UHC in 2019. In progressing towards UHC, countries simultaneously meet other health-related targets set by the UN.
Already, numerous countries have progressed towards UCD, however, the Covid-19 pandemic has stalled progress. Across the globe, healthcare systems were disrupted to respond to the increasing number of hospitalizations caused by the pandemic. To continue to work toward UHC, countries must overcome the pressure that COVID-19 has put on healthcare systems. They must develop infrastructure that allows health services to respond dynamically to crises so that healthcare remains accessible even in times when there is a significantly increased demand for treatment.
To continue to move toward UHC, countries must strengthen their healthcare systems, and strong financial structures are vital to supporting this. Governments must establish financial systems that can reliably fund treatment so that the cost is not left as the patient’s responsibility. Those with low incomes are often unable to fund their own treatment, and even those with considerable incomes may struggle to pay for long-term illnesses. A system that pools funds from government tax revenues and other compulsory funding sources can be effective at spreading the financial risks of illness and injury fairly across the population.
The availability and capacity of healthcare workers are vital to improving health service coverage so that everyone can obtain the treatment they require. The COVID-19 pandemic, while it stretched many healthcare services, shone a light on the importance of healthcare workers. Investments must be increased in this area so that sufficient numbers of staff can be hired to meet the increasing needs of the global healthcare system. It is estimated that by 2030, there will be 18 million additional healthcare workers required. The demand for additional healthcare workers is more pronounced in low- and lower-middle-income countries. If this demand is not met, healthcare inequality may continue to increase.
Investments must be made to create and fill these additional positions. Priority should be given to funding the education and employment of workers. Additionally, it is important that workers are valued and their needs are met. Many healthcare workers are forced to work long shifts in poor working conditions. To ensure low staff turnover, investments must also be made to look after the needs of healthcare works.
Good health is a basis for many important factors, such as facilitating education, helping people to escape from poverty, and supporting long-term economic development. Achieving UHC is not only vital to establishing equal access to healthcare but is also important to helping people escape poverty and to furthering the development of low and middle-income countries.
- Barber, R., et al, 2017. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. The Lancet, 390(10091), pp.231-266. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30818-8/fulltext#articleInformation
- Every year nearly 6 million people die in developing countries from low quality healthcare - this is how we help them. Gabriel Goldschmidt. World Economic Forum. Available at: https://www.weforum.org/agenda/2019/11/effects-and-costs-of-poor-quality-healthcare/
- Tanne, J., 2008. More than 26 000 Americans die each year because of lack of health insurance. BMJ, 336(7649), pp.855.2-855. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323087/
- Universal health coverage (UHC). World Health Organization. Available at: https://www.who.int/news-room/fact-sheets/detail/universal-health-coverage-(uhc)