In this paper, Ajay Tandon and K Srinath Reddy build the case for public financing as absolutely essential for realising the UHC dream. They focus on the argument that UHC is also intrinsically about a policy direction that emphasises at its core redistribution of resources from the well-off to the poor. Differences in the level and organisation of public financing for health for a given level of national income also reflect differences in social and political preferences for redistribution and equity across countries. Hence, navigation of a country’s health financing transition in ways that accelerates progress towards UHC also implies that public resources are targeted and expended in ways to improve effective service coverage and reduce OOP spending specifically for the poor. To leverage a country’s health financing transition for UHC, mechanisms should be introduced for: (i) ensuring that benefit entitlements are explicit and inter-temporally commensurate with levels of public financing; (ii) fragmentation in pooling mechanisms is reduced to facilitate cross-subsidisation without jeopardising equity; (iii) levels of OOP and complementary sources of financing are nudged towards the well-off until core levels of public financing are adequate to provide similar levels of coverage for all; and (v) that purchasing of services is done in ways that help reduce geographic- and income-related inequities in access and supply of quality health services.
Tandon A, Reddy KS. Redistribution and the health financing transition. J Glob Health 2021;11:16001
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