What Universal Healthcare Doesn’t Cover

Charles Kenny examines attempts to provide healthcare in the developing world:

A World Bank review of extending universal health coverage in developing countries found that providing subsidized or free care did increase access to those services, especially by the poorest people. Such schemes also reduced recipients’ out-of-pocket expenses associated with health care. There were also some successes related to health outcomes. Argentina’s Plan Nacer, for example, provided services to pregnant women and young children, which was associated with a 2 percentage point reduction in early newborn mortality.

Yet only five out of 18 studies of coverage roll-out found a positive impact on health indicators such as death rates or reduced sickness.

A big reason why:

In sub-Saharan Africa, the five leading killers are malaria, HIV, lower respiratory infections, diarrhea, and malnutrition. Further and growing causes of mortality across the developing world include traffic accidents, tobacco usage, and health conditions related to being overweight. Clean water, access to and use of toilets, condoms, soap, vaccinations, and and bed nets, alongside better nutrition, tobacco controls, and road safety measures can prevent the majority of these deaths. Doctors and nurses save thousands of lives a day, but infrastructure and public health interventions—neither requiring highly trained medical staff—save many millions each year. Often, the medical system can do little more than provide palliative care when these other approaches aren’t used or don’t work.