Health policy is one of the most important issues on current social policy agendas, and providing sustainable access to affordable and quality health care is a key challenge worldwide.
Photo: M. Crozet/ILO
It is widely recognized that inadequate access and the lack of prepayment systems for health care are barriers to social and economic development. Each year, an estimated 100 million people yearly fall into poverty due to health care costs, implying sharply reduced opportunities for economic growth.
In this context, key policy issues for countries aiming at extending coverage involve choosing the appropriate financing models for different parts of the population as part of an integrated strategy, identifying the essential and cost-efficient benefit package, and ensuring the necessary institutional infrastructure and human resources to enable benefits to be delivered effectively. Clearly, there is no magic formula. The trend towards the establishment of social health insurance schemes as a means of extending coverage, however, reflects positive experiences in a number of countries in various regions.
The practical challenges for extending and securing access to affordable and quality health care differ from country to country. However, strategies must find answers to the common challenges of increasing health care costs arising from innovation in medical technology and drugs, increasing demands from patients, epidemiological developments, demographic changes, inequities in health, and the globalization of the health care market. To cope with these challenges, the focus on financing issues has recently been complemented by increased efforts to make better use of limited resources – to increase the efficiency of the health care system and improve the value for money in terms of health outcomes, quality and consumer satisfaction.
Some of the most important tools and policy measures that are being discussed and implemented at present are early prevention and detection; coordination of different health care sectors and between health care, rehabilitation and community care; health technology assessment; evidence-based guidelines; pay for performance; empowerment of patients; quality and outcome measurement; use of e-health applications, such as electronic medical records; and specific programmes for patients with chronic and long-term conditions.
Extending and securing sustainable access to affordable and quality health care is a key objective of the International Social Security Association (ISSA) and relies in many countries on the performance and capacities of ISSA member institutions. The ISSA’s efforts to provide members with topical knowledge, networks and technical information is targeted at supporting their national efforts to work towards achieving and securing coverage for their populations.