From the CEO: Health for all?

By Elizabeth A. Madigan | 04/05/2019

Universal health coverage is a subgoal of the United Nations’ Sustainable Development Goal 3—to “ensure healthy lives and promote well-being for all at all ages.”

Elizabeth MadiganUniversal health coverage (UHC) has been a focus of attention by the World Health Organization, the International Council of Nurses, and other global healthcare organizations. Universal Health Coverage Day is observed annually on 12 December, the anniversary of the first unanimous United Nations resolution calling for countries to provide affordable, quality healthcare to every person, everywhere. UHC is also a subgoal of the U.N.’s Sustainable Development Goal 3—to “ensure healthy lives and promote well-being for all at all ages.” Despite growing awareness of the terms “universal healthcare” and “UHC,” it is not always clear what they refer to.

According to the World Health Organization (WHO), “Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.” Although WHO advises government leaders of U.N. member countries, they cannot and do not specify how the objective of universal health coverage happens in any country. In other words, there is no United Nations recommendation on how countries organize, finance, or administer their health programs, only that the goal is UHC availability and use of all kinds of health services for all citizens, provided effectively and affordably. This is a tall order!  

As nurses and nurse leaders, we, of course, support the goal that all kinds of health services should be available and accessible for use by all people. We also support effective use of all kinds of health services. The affordability part is where we sometimes get hung up. While we support the argument that affordability should be part of any country’s healthcare system, it’s the “how” that evokes strong feelings in some nurses.

Most of us are not economists—some of us are—and policy issues related to financing healthcare systems affect many areas: workforce decisions (how many nurses are needed to deliver universal healthcare and how much they are paid), personal finance (taxes of some kind are a common source of financing), and philosophical and personal beliefs about the proper role of government in financing and administering healthcare. In other words, affordability and financing are complicated. Regardless of the complexity, however, there is general agreement among nurses that people should not have to defer needed care—or be unable to receive needed care—because of their inability to pay. Bottom line? The goal of universal healthcare—UHC—is consistent with nursing’s aim to care for all, regardless of background or situation.

Nurses represent more than 50% of the world’s healthcare workforce. As nurse leaders located in more than 90 countries, members of Sigma Theta Tau International Honor Society of Nursing (Sigma) are ideally positioned to advocate for changes that bring about UHC—affordable healthcare available to all—in our particular localities. No progress will be made on UHC without us. So, for Nurses Day (12 May) this year, we join our colleagues at the International Council of Nurses in promoting that organization’s theme: Nurses. A Voice to Lead, Health for All. RNL 

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Elizabeth "Liz" Madigan, PhD, RN, FAAN
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