Universal Health Systems: A Better Pathway To Achieving Universal And Equitable Access To Comprehensive Healthcare

The current Universal Health Coverage (UHC) strategy aims to improve health services coverage, financing, and financial protection with equity, especially in the LMICs. Despite being the main framework for health policies and reforms, the results have been poor. Coverage stagnated and financial protection retreated. Insurance-based models and restricted basic services packages boosted the healthcare market but couldn’t improve access and worsened inequalities. Primary care was constrained by fragmentation and segmentation. Private provision preference led to exclusion, unaffordable prices, and poor-quality care in secondary and tertiary care. The COVID-19 pandemic exposed unaddressed systemic barriers such as inequitable access to health technologies, the international disparity of power and resources, the unbalanced corporate power, and the need to strengthen the public sector. In this context, the international community should revisit concepts, principles, guidelines, and strategies for achieving UHC as the current framework is no longer fit for purpose. This Policy Brief provides a critical evaluation of the UHC developments and presents the Universal Health Systems (UHS) as a better alternative to achieving universal and equitable access to comprehensive healthcare. Based on the evidence and lessons learned, both approaches are compared considering dimensions such as the role of the state, financing, access, and equity. An updated universalization strategy should conceive healthcare as a common good and require reclaiming the role of the state in social protection and provision based on principles of solidarity, cooperation, social justice, and participation.