Universal Health Coverage and Primary Health Care: Their Place in
People’s Health
Abstract
Sturmberg and Martin in 2020 argue that Universal Health Care (UHC) is
mainly about financing and Primary Health Care (PHC) is about the right
care at the right time to ensure health. They maintain the World Health
Organisation (WHO) has recently sent the wrong message about the
“pillars” of PHC in their relationship to UHC. An understanding of
political economy is required in order to come to terms with the bases
of PHC and the fundamentals of UHC, that dealing with inequities is not
only an economic issue but fundamentally a political issue. Neoliberal
decision making can enhance inequities in society. Two chronic health
conditions, diabetes and multiple sclerosis are examples of conditions
that lead to costly and debilitating consequences for patients but also
lead to substantial economic costs in terms of lost workforce
participation and lost productivity. These cases demonstrate the
socio-political issues involved in the management of care for a number
of illnesses. The upsurge of COVID–19 has placed an enormous strain on
health and broader social and economic resources and challenged the
pretext of UHC as health for all: substantial differences in equity and
political commitment have emerged. Sturmberg and Martin argue that the
joining of UHC and PHC needs leadership which involves local communities
and resourcing. PHC is a changing system based on power relationships
involving funders and the health community. In Australia as in several
countries out of pocket costs have grown rapidly and have affected
access for some groups to PHC and have challenged the pretext of equity
in UHC. In the context of PHC and UHC we support the position that
health for all goes beyond healthcare for all, to embrace healthy lives
promoting wellbeing.