GENEVA/TAIPEI - Millions of people worldwide face financial ruin; their assets wiped out because of a catastrophic illness or accident that saddles them with staggeringly high health bills they are unable to pay.
This nightmare scenario rarely, if ever, occurs in countries that have universal health coverage. Such systems insulate people from the financial disasters that occur in countries where national health schemes do not exist.
“Today, about 100 million people fall into poverty because of health expenditure,” said Rudiger Krech, World Health Organization director for health systems and innovation. He told VOA that every country, poor and rich alike, can afford universal health coverage.
“It is not just a matter of money, but of political will, of political choice. So, you can afford health coverage for everyone, even if you are not one of the most affluent countries in the world,” he said.
For example, he said that relatively low-income countries such as Cuba and Costa Rica have developed good health systems; while in the United States, one of the world’s richest countries, “people have to pay huge amounts of their salaries and their income for health services.”
“We call these catastrophic health expenditures because people are losing their fortune because they had a big accident or an open-heart surgery,” he said. “So, this still pulls people into poverty.”
Half of world lacks full coverage
The World Health Organization reports at least half of the world’s population lacks full coverage for essential health services. More than 800 million people, or nearly 12 percent of the world’s population, spend at least 10 percent of their household budgets to pay for health care, WHO said. In 2015, it said the world spent an eye-watering $7.3 trillion on health, representing close to 10 percent of global Gross Domestic Product.
WHO is on a mission to make it possible for all people and communities to receive the health services they need without suffering financial hardship. As such, it is using this year’s World Health Day, April 7, to promote the U.N. Sustainable Development Goal that calls for the adoption of universal health coverage in 90 percent of the world’s countries by 2030.
“I think this is a goal that people all over the world should aspire toward,” said Shih-Chung Chen, Taiwanese minister of health and welfare.
“I will not say that it will be achieved by 2030,” Chen told a group of visiting journalists, “but I think all countries should have the willingness to try to achieve this, and that is why we want to participate in the World Health Assembly. That would allow us to contribute toward that goal.”
Last year, China blocked Taiwan from participating in the WHA as an observer and, so far this year, Taiwan has not received an invitation to attend.
“I think that in order to ensure that health is a basic human right, no country’s experience should be left out,” said the Taiwanese health minister. “We are extremely proud of our universal health coverage system. I think this would be a very important way for us to share with the world.”
Taiwan’s single payer National Health Insurance, a compulsory program that was launched in 1995, provides comprehensive, affordable coverage for the island’s more than 23 million inhabitants. The government calculates “a family of four pays roughly $100 U.S. per month as the premium.” This comes to about 2 percent of the average household income. Average life expectancy in Taiwan has risen to 80 years, on a par with Organization for Economic Cooperation and Development (OECD) countries.
“More than 85 percent of the people in Taiwan report very high satisfaction with our national health Insurance,” Chen said.
Low health expenditure
The health minister told VOA that Taiwan’s total health expenditure is 6 percent of GDP, the lowest in the world, compared with more than 16 percent for the United States.
“The U.S. is entirely capable of providing universal health care to its citizens,” he said. “However, because the U.S. has a multitude of systems in place that have been there for a long time and there are a lot of stakeholders involved, it would be a bit difficult. In addition, the U.S. places a lot of importance on freedom of choice.”
Chen said the world could learn a lot from Taiwan’s health insurance program. Unfortunately, he said Taiwan was not able to help because it is barred from participating in international organizations such as the World Health Organization.
Krech told VOA it was the United Nations, not WHO, that decided whether Taiwan could be included in international health matters.
“We are talking to Member States and obviously Taiwan is not a Member State. But, it is Chinese Taiwan and Chinese Taipei and, therefore, it is under this “One China” policy.
“That does not bar us from discussing with representatives of Chinese Taipei, at all,” he said. “We have regular exchanges. We see what is happening.”
This story was written by Lisa Schlein.