Latin America Faces Opportunities and Challenges in the Goal to Achieve Universal Health Care Coverage

São Paulo, Brazil—16 September 2017—The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) held a plenary session at its 6th Latin America Conference today exploring the challenges and opportunities inherent in the move many of the region’s countries are taking toward universal health care coverage.

A number of countries in Latin America are implementing health care reforms toward the goal of universal coverage in response to the World Health Organization having proposed universal health care coverage as a strategy to fight inequity in access to health care. Successful execution of universal health care, however, has posed a challenge for many countries in Latin America where health policy is often still under debate. The session was moderated by Eduardo González-Pier, PhD, Distinguished Visiting Fellow, Center for Global Development, Washington, DC, USA. Speakers included Rubén Torres, MD, PhD, Dean, ISALUD University, Buenos Aires, Argentina; Mauricio Vargas Fuentes, MD, MSc, Director, Public Health School, Universidad de Costa Rica and Secretariat, Latin America Alliance for Global Health, ALASAG, San Pedro, San Jose, Costa Rica; Jesús Ancer Rodriguez, MD, Secretary, General Health Council, Mexico City, Mexico; Jairnilson Silva Paim; MMed, PhD Professor, Health Policy and Planning, Health Situation Analysis and Urban Violence and Health, Instituto de Saúde Coletiva, Federal University of Bahia, Bahia, Brazil; and Tomás Pippo Briant, MSc, Coordinator, Medicine, Technology, and Health Research Unit, Pan America Health Organization (PAHO)/Americas office of WHO in Brazil, Brasilia, Brazil.

Moderator, Eduardo González-Pier, PhD, initiated the discussion by defining universal health coverage as “all people receiving quality health services that meet their needs without exposing them to financial hardship in paying for them.” He described the dimensions of universal health coverage outlined by the World Health Organization as expanding 1) the population covered, 2) the direct costs covered, and 3) the services covered.

The common theme throughout the panel discussion was that each country’s social commitment to universal health coverage is also challenged with providing a consistent level of coverage and access across populations. The panel discussed how integration and sustainability of health care services can be facilitated through better funding, constant attention to efficiency and quality, and careful consideration of the evidence supporting the safety, effectiveness, and health economics of those services.

Mauricio Vargas Fuentes, MD, MSc began the country-by-country discussion by highlighting Costa Rica’s commitment to universal health coverage and to the provision of health services in a democratic fashion. Costa Rica’s system of universal health coverage was established in 1924.

Jairnilson Silva Paim, MMed, PhD described the evolution of the Brazilian health care system since the middle of the 20th century, noting that it began with a high degree of fragmentation. In 1988 Brazil’s constitution established health care as a right of citizenship and the country has since had an ongoing effort to coordinate health care services across the Brazilian states.

Jesús Ancer Rodriguez, MD discussed Mexico’s century-long commitment to the right of health care for all its citizens and described how the country has worked to overcome the fragmentation that results from different sources of health coverage across their society.

Rubén Torres, MD, PhD described the Argentinian health care system as highly fragmented with 3 distinct sectors (social security, private, and public). This fragmentation results in significant inequity in coverage of health care services. He urged political leaders to recognize the importance of improving equality in health care as a matter of justice in society.

Tomás Pippo Briant, MSc described the Pan America Health Organization’s goal of not simply delivering health care, but also expanding the integration of services and eliminating direct expenses that can impoverish individuals. He pointed out that 2 important approaches toward this goal include eliminating inefficient health care services (that can be 30-40% of all services) and intersectoral action to improve the social determinants of health.

Additional information on the ISPOR 6th Latin America Conference can be found here. Released presentations from the conference can be found here. Interested parties can follow news at ISPOR’s press site and on social media using the conference hashtag #ISPORSaoPaulo.

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