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Universal Health Coverage and Primary Health Care: Their Place in People’s Health
  • Christine Walker,
  • Chris Peterson
Christine Walker
Chronic Illness Alliance

Corresponding Author:cwalker@chronicillness.org.au

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Chris Peterson
La Trobe University
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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.
11 Jun 2020Submitted to Journal of Evaluation in Clinical Practice
11 Jun 2020Submission Checks Completed
11 Jun 2020Assigned to Editor
12 Jun 2020Reviewer(s) Assigned
20 Jun 2020Review(s) Completed, Editorial Evaluation Pending
21 Jun 2020Editorial Decision: Revise Minor
23 Jun 20201st Revision Received
24 Jun 2020Submission Checks Completed
24 Jun 2020Assigned to Editor
25 Jun 2020Review(s) Completed, Editorial Evaluation Pending
25 Jun 2020Editorial Decision: Accept
27 Jul 2020Published in Journal of Evaluation in Clinical Practice. 10.1111/jep.13445