Social Health Protection: addressing inequities in access to health care
12-23 March 2012, Turin, Italy
As early as 1944 the International Labour Conference defined adequate medical care as essential element in social security and adopted the Medical Care Recommendation calling for a medical care service covering all members of the community, whether or not gainfully occupied. Still, nearly 90 per cent of people living in countries with very high vulnerability levels are not covered formally by any scheme or system. This has a tremendous impact on life expectancy, child mortality, maternal health and the spread of major diseases including HIV/AIDS. In low income countries out-of-pocket payments account for 45% of the total health expenditure implying that millions of people face catastrophic healthcare costs because of direct payments such as user fees, while 100 million are driven below the poverty line each year.
At national level, access to health care contributes to the improvement of the national health status overall, and to building human capital that yields economic profi ts through gains in productivity and higher macroeconomic growth. Though included in most national constitutions as essential service to their citizens, many countries struggle to make available healthcare services and ensure affordability for households. Universal access to health care can be provided through a variety of models though every system needs to master specifi c challenges (under-funding, raising costs, inefficiency, quality of services, accessibility, etc.).
Recognizing the importance and necessity of adequate social protection systems, the United Nations System Chief Executives Board adopted in April 2009 the Social Protection Floor Initiative aiming at providing minimum access to essential services and transfers to the population in need of such protection. Reaffirming the central role health-care services play for sustainable development, universal access to it constitutes a key component of the Social Protection Floor.
The course will identify inequities in effective access and main causes, review the importance of universal access to health care in crisis and post crisis situations, issues related to the feasibility of introducing a scheme and planning for implementation; designing the appropriate contribution levels and benefits, monitoring the provision of services and ensuring the sound governance and financing of the scheme.