While ‘Obamacare’ under fire, universal care catches on globally

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Even as the Obama administration comes under scrutiny for overhauling healthcare and requiring all citizens to have insurance in the United States, the idea of universal healthcare is taking off elsewhere around the globe, according to a new report from the Council on Foreign Relations.

“Unlike the United States, emerging economies are not buying the argument that healthcare is largely the responsibility of individuals and businesses, with a public provision relegated to the elderly, veterans and the indigent,” writes Yanzhong Huang, its senior fellow for global health.

Government plans that aim to ensure universal health coverage have been launched everywhere from Kyrgyzstan to India to Brazil. Though the programs differ from country to country, they share the idea of splitting the costs of care broadly so that a sudden illness doesn’t plunge someone into poverty.

As of three years ago, nearly 50 countries had achieved almost universal health coverage, International Labor Organization data show. China had 95% of its citizens covered by the end of last year, the official New China News Agency reported last month. If more countries follow the lead of countries such as China, India and Rwanda, the Council on Foreign Relations report argues, most people in the world could have affordable healthcare in a decade.

Expanding health coverage has created some striking success stories elsewhere in the world: Six years after Thailand started its program, both rich and poor people ended up spending half as much on unexpected health catastrophes as they had previously, according to the report.

Yet “health coverage is not a guarantee of lower out-of-pocket costs or reduced financial hardship,” the report finds. In the Philippines, for instance, private hospitals sometimes charged higher prices to treat people using government insurance, hiking their out-of-pocket costs to generate the same revenue.

Other effects have been mixed worldwide. Universal health coverage led to dramatic increases in the number of times that people visited the hospital in Rwanda and Taiwan, but not in the Chinese countryside, where the government created a rural health coverage program.

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-- Emily Alpert in Los Angeles