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Making fair choices on the path to universal health coverage: applying principles to difficult cases

Voorhoeve, Alex, Edejer, Tessa T. T., Kapiriri, Lydia, Norheim, Ole Frithjof, Snowden, James, Basenya, Olivier, Bayarsaikhan, Dorjsuren, Chentaf, Ikram, Eyal, Nir, Folsom, Amanda, Hussein, Rozita Halina Tun, Morales, Cristian, Ostmann, Florian, Ottersen, Trygve, Prakongsai, Phusit, Saenz, Carla, Saleh, Karima, Sommanustweechai, Angkana, Wikler, Daniel and Zakariah, Afisah (2017) Making fair choices on the path to universal health coverage: applying principles to difficult cases. Health Systems & Reform, 3 (4). pp. 1-12. ISSN 2328-8604

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Identification Number: 10.1080/23288604.2017.1324938


Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This paper by some members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC.

Item Type: Article
Official URL:
Additional Information: © 2017 The Authors © CC BY 4.0
Divisions: Philosophy, Logic and Scientific Method
Subjects: B Philosophy. Psychology. Religion > B Philosophy (General)
R Medicine > RA Public aspects of medicine
Date Deposited: 05 May 2017 09:12
Last Modified: 29 May 2024 18:57
Projects: AH/J006033/1
Funders: Arts and Humanities Research Council

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