SEHAT Sahulat is a great programme but universal health coverage has a much larger vision. Sehat Sahulat is a state-financed health insurance system for the curative care of hospitalised patients, whereas UHC means healthcare for all. After the universalisation of the Sehat Sahulat programme in the federal areas, KP and Punjab, the term ‘universal health insurance’ is increasingly being used in policy discussions. Many senior policymakers — bureaucrats and politicians — continue to equate UHI with UHC. Indeed, there is conceptual overlapping between the two but they are not the same. It is vital to understand the overlaps and distinctions as they can misguide policymaking. Let’s unpack this further.
The World Health Organisation’s definition of UHC is, “when all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship”.
There are four key interlinked components of UHC according to the above, universally accepted conceptualisation: accessibility to all people; access to needed health services; health services of quality; and financial protection of those who cannot pay.
Let me begin with the last one. Financial protection is one of the four main coverage goals of UHC, and it is particularly important for the poor. Once financially protected, one doesn’t have to make excessive out-of-pocket payments at the point of care, thus obtaining access to healthcare without experiencing financial hardship. Specific terminologies used by health economists........