Universal Health Coverage

Universal health coverage, UHC, means that all people can obtain the health services they need, of adequate quality, without suffering financial hardship. It covers promotive, preventive, curative, rehabilitative and palliative services across the life course. UHC is a health-system goal, not merely a particular insurance scheme or a promise that every possible treatment will be free.

Core dimensions

UHC requires simultaneous progress in who is covered, which services are available, and how much of their cost people must bear.

• Population coverage requires access based on health need, including for poor, rural and otherwise vulnerable groups.
• Service coverage includes a comprehensive continuum from health promotion and prevention to treatment, rehabilitation and palliation.
• Financial protection seeks to prevent necessary healthcare from causing impoverishment or catastrophic household expenditure.
• Effective coverage also requires services to be safe, timely and of sufficient quality; nominal entitlement alone is inadequate.

How public policy advances UHC

UHC depends on a strong public health system rather than on hospital insurance alone. Policy must combine service delivery with pooled financing and effective regulation.

• Comprehensive primary healthcare should provide first-contact care, prevention, early diagnosis and referral to higher levels.
• Public financing and risk pooling spread costs across the population and reduce dependence on direct out-of-pocket payments.
• Adequate health workers, medicines, diagnostics, infrastructure and information systems determine whether entitlements become real access.
• Regulation and strategic purchasing are needed to maintain quality and accountability across public and private providers.

Constitutional and governance context

Under Article 47, improvement of public health is among the State's primary duties. Entry 6 of the State List covers public health and sanitation, hospitals and dispensaries, making State capacity central while requiring coordination and support across levels of government.

How UPSC asks this