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Universal health coverage and user charges

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  • Smith, Peter C.

Abstract

There has been an explosion of interest in the concept of ‘universal health coverage’, fuelled by publication of the World Health Report 2010. This paper argues that the system of user charges for health services is a fundamental determinant of levels of coverage. A charge can lead to a loss of utility in two ways. Citizens who are deterred from using services by the charge will suffer an adverse health impact. And citizens who use the service will suffer a loss of wealth. The role of social health insurance is threefold: to reduce households’ financial risk associated with sickness; to promote enhanced access to needed health services; and to contribute to societal equity objectives, through an implicit financial transfer from rich to poor and healthy to sick. In principle, an optimal user charge policy can ensure that the social health insurance funds are used to best effect in pursuit of these objectives. This paper calls for a fundamental rethink of attitudes and policy towards user charges.

Suggested Citation

  • Smith, Peter C., 2013. "Universal health coverage and user charges," Health Economics, Policy and Law, Cambridge University Press, vol. 8(4), pages 529-535, October.
    • Handle: RePEc:cup:hecopl:v:8:y:2013:i:04:p:529-535_00
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    Cited by:

    1. K. P. M. Winssen & R. C. Kleef & W. P. M. M. Ven, 2016. "Potential determinants of deductible uptake in health insurance: How to increase uptake in The Netherlands?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1059-1072, December.
    2. Fengping Tian & Jiti Gao & Ke Yang, 2018. "A quantile regression approach to panel data analysis of health‐care expenditure in Organisation for Economic Co‐operation and Development countries," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1921-1944, December.
    3. Thomas Lefèvre & Claire Rondet & Isabelle Parizot & Pierre Chauvin, 2014. "Applying Multivariate Clustering Techniques to Health Data: The 4 Types of Healthcare Utilization in the Paris Metropolitan Area," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-20, December.

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