Article published on "Universal Health Coverage: Cure the System, Cover Everyone " in Newspaper, India

Universal Health Coverage: Cure the System, Cover Everyone

(On Universal Health Coverage Day, 12th December 2025)

Health plays a major role for the development of any nations. Major countries have visions focused on economic growth, global influence, and sustainable development, often with a 2030 or 2047 timeframe. Examples include India's goal of becoming a developed nation by 2047 (Viksit Bharat 2047), Saudi Arabia's "Vision 2030" for economic diversification, and Egypt's "Vision 2030", Vision’s of American and European countries. A healthy population can contribute to the achievements of any vision including the Viksit Bharath 2047 in India to Sustainable Development Goals (SDGs) in the world.

However, whether the health systems of the various nation have the proper facilities or not and are this health systems can provide health coverage for the citizens or how the health expenditure of the people have been met i.e. is it by health coverage or people are paying by themselves (out of pocket expenditure), whether the people have the ability to pay for the health services etc. are some of the major issues in health systems.

Universal Health Coverage (UHC) Day – December 12, 2025

Universal Health Coverage Day is observed every year on December 12 to promote the global movement for “health for all.” The day marks the anniversary of the United Nations General Assembly’s (UNGA) 2012 resolution, which unanimously recognized Universal Health Coverage as essential for realizing human rights and sustainable development. In 2014, the Universal Health Coverage Coalition officially proclaimed December 12 as UHC Day, and in 2017, the UNGA formally declared it as International Universal Health Coverage Day. UHC represents a fundamental human right — ensuring that all individuals and communities can access the health services they need without suffering financial hardship.

The theme for UHC Day 2025 is “Unaffordable health costs? We’re sick of it!” This year’s campaign underscores the growing burden of unaffordable healthcare costs that force people to delay treatment or face economic strain, urging global leaders to prioritize policies that guarantee financial protection and equitable healthcare for all.

Universal Health Coverage in India:

The World Health Organization (WHO) reports that the world is not on course to achieve Universal Health Coverage (UHC), a key target under the Sustainable Development Goals (SDG 3.8), by 2030. Since 2015, progress in expanding access to essential health services has slowed, while the share of people facing catastrophic out-of-pocket health expenses has continued to rise — a trend observed across all regions. Between 2000 and 2021, the proportion of people without access to essential health services declined by only about 15%, showing limited advancement in recent years. As of 2021, nearly 4.5 billion individuals still lacked full coverage for essential health services. Financial hardship due to healthcare costs remains a major global concern, with around 2 billion people affected — including 1 billion facing catastrophic health expenditures (SDG indicator 3.8.2) or approximately 344 million pushed further into extreme poverty as a result of medical expenses.

India continues to advance toward Universal Health Coverage (UHC) through a range of national health programmes designed to make healthcare accessible and affordable for all citizens.

Key initiatives include Ayushman Bharat (2018), National Health Mission (NHM) (2013), Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP), Central Government Health Scheme (CGHS), Employees’ State Insurance (ESI) etc. These initiatives collectively reflecting India’s commitment to building an inclusive healthcare system and advancing equitable access to essential health services for all citizens.

A recent report by Swiss Re highlights that India has experienced the highest increase in financial strain from out-of-pocket (OOP) healthcare expenses among 12 Asian nations between 2017 and 2024. During this period, Indian households have come to bear nearly 60% of the country’s total health expenditure — significantly higher than the regional average. Despite the introduction of various public health schemes, overall insurance coverage remains limited, with only about one-third of medical expenses insured. The remaining two-thirds are paid directly by families, particularly in cases involving chronic and critical illnesses. The report also notes that while many individuals express an intention to purchase life insurance, factors such as high premiums, limited awareness, and perceived lack of value continue to hinder wider adoption of insurance coverage in India.

Way Forward:

Despite the implementation of multiple government schemes and insurance initiatives, a large share of healthcare spending in India continues to come directly from people’s pockets. The burden of unaffordable medical costs is driving many families into poverty, worsening health inequalities, and slowing progress toward national development and the Sustainable Development Goals (SDGs). This growing challenge underscores the urgent need to strengthen public awareness and advocacy for Universal Health Coverage (UHC). Greater public engagement can help highlight the inequity of unaffordable healthcare and urge policymakers to increase investment in accessible, affordable, and equitable health systems for all.

The World Health Organization (WHO) collaborating with a wide range of global and local partners to promote Universal Health Coverage (UHC) across nations. To accelerate progress, WHO emphasizes the need to rebuild and strengthen health systems through a Primary Health Care (PHC) approach. According to WHO, expanding PHC-based services in low- and middle-income countries could save an estimated 60 million lives and extend the average life expectancy by 3.7 years by 2030. This approach ensures equitable access to essential health services and supports stronger, more resilient healthcare systems worldwide.

Governments should prioritize reducing out-of-pocket (OOP) healthcare expenditures and intensify efforts to make health insurance both affordable and accessible to all. This requires policy measures that strengthen financial risk protection, expand subsidized insurance schemes, regulate premium costs, and enhance coverage for essential services. Advancing these initiatives with genuine commitment will contribute significantly to achieving equitable and sustainable Universal Health Coverage. Although governments are continuously striving to expand healthcare services amid growing population demands, achieving Universal Health Coverage requires a multi-sectoral approach. Governments can strategically encourage private insurance providers to offer affordable and inclusive health insurance plans. This may be accomplished through supportive regulatory frameworks, public–private partnerships, targeted subsidies, and incentives that promote wider coverage, reduced premiums, and enhanced service quality. Such measures can help ensure that essential healthcare becomes accessible and financially protected for all segments of the population. Unless these measures are implemented, the protection gap will continue to widen, undermining the goal of true universal coverage. It is time to unite our voices and declare: “We’re sick of unaffordable health costs!” Let us call for action — Cover Everyone, Cure the System — because Health is a Right, Not a Privilege.

Dr. Ramaiah Itumalla

The Author is a Professor of Healthcare Management and Policy at The Apollo University, Chittoor, A.P.