MHST 601: What Universality Means To Me

What is universal health care?

According to the World Health Organization (WHO), universal health coverage means that “all people have access to the full range of quality health services they need, when and where they need them, without financial hardship.” This covers a full continuum of essential health services such as health promotion, medical treatments, rehabilitative services and palliative care (WHO, 2023).

With this in mind, when I ponder the question of what universality means to me, I think about the UK’s National Health Service (NHS) which provides health care to the entire UK population free of charge. Although by definition it is a universal system, in reality the NHS is often criticized for having excessive wait times and barriers to service like location, race, gender, socioeconomic factors. Additionally, there are private health care options available for people who have the means to pay for private medical treatments.

Is Canada's healthcare system truly universal?

In contrast, I do not consider Canada’s health service to be a universal system because coverage is limited to “medically necessary” hospital and physician services, to the exclusion of “vital goods and services such as outpatient pharmaceuticals, dental care, long-term care, and many mental health services” (Flood & Thomas, 2016). As a result, many individuals navigating the system suffer health disparities due to gaps within the services provided. Much like the UK, Canada’s marginalized groups such as Indigenous peoples, sexual and racial minorities, immigrants, and people living with functional and socioeconomic limitations face disparities within the system (Public Health Agency Canada, 2023).

Is true universality a pipe dream?

Although privatization in the UK can improve accessibility within the free system, it can also create an environment where people with the means to pay, can jump the queue and gain better health outcomes as a result of their privilege, which is an approach that may not address the deep-rooted disparities that many will continue to experience. In an ideal world, I would like to see a barrier-free universal system where everyone can access needed healthcare. However, I struggle with the notion of a free system because as demonstrated in the UK, providing free healthcare does not necessarily reduce the systemic barriers.

References

Canadian Health Act, RSC 1984, c C-6, s.3 (2017). https://laws-lois.justice.gc.ca/eng/acts/c-6/fulltext.html. Retrieved 2 Oct 2023

Flood, C., M. & Thomas, B. (2016). Modernizing the Canadian Health Act. Dalhousie Law Journal, 39(2), 398-411. National Health Act. (2006). https://www.legislation.gov.uk/ukpga/2006/41/contents

Public Health Agency of Canada. (2023). Social determinants of health and health inequalities. Government of Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html. Retrieved October 1, 2023

Williams E, Buck G, Babalola D, Maguire G. The Kings Fund, What are health inequalities? June 17, 2022. https://www.kingsfund.org.uk/publications/what-are-health-inequalities#:~:text=Created%20with%20Datawrapper-,Inequalities%20in%20long%2Dterm%20health%20conditions,in%20higher%20socio%2Deconomic%20groups. Retrieved 2 Oct 2023

World Health Organization. (2023). Universal health coverage. https://www.who.int/health-topics/universal-health-coverage#tab=tab_1. Retrieved October 3, 2023