Which countries can claim to have universal health coverage?
In this week’s infographic we look at OECD data on health coverage across several countries and compare it to survey data on the percentage of people satisfied with the availability of quality health care in the area where they live.
The OECD collects data on the percentage of countries’ populations which are eligible to receive core health care services, which it defines as a set of services including consultations with doctors, tests and examinations, and hospital care, via coverage by either nationalised health care systems or social or private health insurance cover. We present its latest coverage data, from 2020 or more recently, for selected countries.
The core services coverage rate across the OECD as a whole was 98% in 2020. We used this is as a benchmark to determine which countries have universal health coverage (requiring 100% coverage seems a little unfair given several countries had a coverage rate very close to 100%).
Only nine of the 38 countries did not have universal (or very nearly universal) coverage: Chile, Colombia, Costa Rica, Estonia, Hungary, Mexico, Poland, Slovakia and – of course – the US.
The US had a coverage rate of just 89.8%, which was the second lowest after Mexico (80%). Whilst Obama’s Affordable Care Act (“Obamacare”) did technically make having health insurance mandatory for US residents, and this did lead to the number of uninsured Americans roughly halving between 2014 and 2016, Donald Trump removed the tax penalty for this in 2019 meaning there is now effectively no mandate to be insured at the federal level.
We also included OECD data on the percentage of people who are satisfied with the availability of quality health care in the area in which they live. This data, whilst admittedly subjective, paints a somewhat different picture. Perhaps unsurprisingly, multiple countries with 100% or close to 100% coverage have significant percentages of people saying they are not satisfied with the availability of quality health care facilities in the area in which they live.
In light of this, perhaps the concept of ‘universal health care’ should encompass (geographic) accessibility to timely and quality health care, as well as financial coverage. Achieving a rate of 100% on the latter is certainly necessary, but perhaps not sufficient, for a country to be able to claim it has true universal health care.
The above data is taken from the OECD’s ‘Health at a Glance 2021’ report.
We would welcome your thoughts on this story. Email your views to Martin De Benito Gellner or call 0207 183 3779.
