Pros And Cons Of Universal Health Insurance – Women’s Health and Gender Studies Health financing is focused on activities that do not support women’s equity in public health in the 2020; 371 doi: https://doi.org/10.1136/.m3384 (Published 27 October 2020) Retrieved from: 2020; 371:m3384 Read our Women’s Health and Inequality collection
Global commitments to improve women’s access to health care have been made repeatedly, most recently through the sustainable development goals and the 2019 political declaration on public health. These commitments represent the vision of the 1995 Beijing Declaration to ensure that women have access to fair, appropriate, affordable and effective health care throughout their lives. However, 25 years later, women are still failing, and their basic health needs are still not being met.
Pros And Cons Of Universal Health Insurance
In low- and low-income countries, 45 million pregnant women (37%) do not have, or lack access to, prenatal care, 214 million women (13%) want to avoid pregnancy by the use of modern antibiotics, and 266 000 women die from cervical cancer which can be largely prevented (90% of deaths worldwide due to the disease).1 In high-income countries women’s lack of access to health care because of cost—for example, 26% of women in Switzerland and 38% in the United States.23
Health Insurance Coverage In The United States
In addition to the general challenges that hamper public health, health systems and the broader political economy that limit women’s access, which reflects and reinforces women’s limitations, power inequities, and discrimination. income, and often limited decision-making power over family resources and their own health care, combine to create significant barriers to health care.4
This power increases when the financing of health care is linked to work qualifications, because women experience inequality and difficulty participating in work. Employment-based health financing systems can translate gender differences in employment into unequal access to health care, further disadvantaging mothers. .
Employment-based health insurance includes any type of health insurance or allowance related to an individual’s status and type of employment. Typically, joint contributions from an employee, their employer, and/or the state are sent to the provider for a set of health benefits. for contributors, and sometimes their dependents. Such programs include compulsory contributions to national social insurance (Thailand), enrollment of informal workers and non-regular workers (ie, part-time and informal workers) in life insurance programs. health (Ghana, Vietnam), and voluntary or partial health – empowerment. insurance from employers in their labor market (USA). Examples of employer-provided health insurance include the South African government employee medical scheme with five levels of benefits. , which relates benefits (beyond the basic package) to costs5; and US policies for providing health care to full-time employees who work for employers with more than 50 full-time employees.6
There are many criticisms of performance-based health financing. First, it suggests that health is an occupational benefit, rather than a human right. Second, by tying health care to employment or special contributions, it undermines the goal of public health to ensure equality and continue to achieve the growth of the highest level of health. In some cases, people in higher occupations have more health rights or can pay higher insurance premiums to get better health care and expensive Ideally, public health initiatives should begin with the poor who have the highest health needs.7 Although countries can combine financing of performance-based health with comprehensive care aid for vulnerable groups, there is a higher risk of excluding people from falling in, or moving up. . between them, different groups of rights, such as those defined by socio-economic status, poverty line, and pregnancy status. Finally, as a source of health income, employment-based health financing is unstable, fragmented, and unequal, especially in times of economic crisis.89 In during the covid-19 pandemic in the US, approximately 47.5 million people lost access to health-related jobs. in the absence of work in the family. As of May 2020, 27 million of them appear to be uninsured because they do not qualify for other health plans.10
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Rights to public health care, forced inclusion in national programs, general taxation for pooling resources, and opt-outs Voluntary or shared benefits are suggested to overcome challenges in this transition. Performance-based health financing remains an important source of income, especially for low- and middle-income countries that need additional resources. internal. Existing payment structures can also be used.8 In countries with employment-based health financing systems, it is often prevented by the influence of those who have these privileges to reform these regulations, which continue to harm women.811
Gender inequality and the gap in employment have barely changed in the last 25 years. Globally, it was estimated that only 47% of women were employed in 2019, compared to 74% of men.12 With this employment gap, and a gender pay gap that almost 20%, did not achieve equality in work. 13
Unpaid caregiving and the inequality of domestic work between men and women persist throughout the world, affecting women’s economic participation and opportunities. Women do more than 80% of unpaid care work, and about 606 million women, compared to 41 million men, are full-time unpaid workers.1314
In the official sector, women continue to excel in higher positions and receive unequal recognition for the same role, skills, education and experience. The majority of employment opportunities continue to be for women and children.14 The number of women in the world (about 27%) in managerial and professional leadership is almost changed to 30 years.14 The most economically disadvantaged women are not working full-time. or the official part.15
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The informal sector provides employment for up to 90% of working women in Africa and South Asia, and 75% in Latin America.14 Typically, young women (15-24 years) and women elderly (>65 years) are more uncommon. woman. jobs, 16 and they have focused on jobs with low wages, long hours, and insufficient or no social security. 14
These gender inequalities may increase in the future. The changing work environment around the world based on technological disruptions, economic changes, and the reduction of social security and work conditions are reducing the opportunities for permanent and stable work.14 It is increase in irregular work arrangements, such as part-time contracts and temporary contracts. in the official sector. 1617 Similar to informal work, these arrangements often lack social protection and health work safety, because they are organization of the “employee”. Again, women are disproportionately affected. In Japan, where national health funding is based on employment, women are four times more likely to be on a temporary contract.18 Women in developing countries comprise one in five employees, who use computers to generate income based on work or services. 14 The online “gig” economy is not intended to close gender gaps in employment or income.14
Atypical work arrangements are often shown to support women’s participation in paid work by providing flexibility and enabling and balancing their economic and social responsibilities.19 However, non-standard workers often have a higher income gap of 60% compared to imperfection. temporary workers, even in rentier countries.17 In times of economic hardship and periods of recovery, women are disproportionately represented in non-traditional jobs, especially in industries or roles that heavily dependent on women, such as industrial service.
Socio-economic and cultural factors affect women’s ability to participate in paid work throughout their lives.15 Women are less likely to have long-term contracts, 20 and their working lives are often divided into transitions, due to reproduction, responsibility of care, and conscience and conscience. no job. .
Universal Healthcare Pros And Cons
Employment-based policies often ignore these inequities and changes in women’s employment, often resulting in gaps in coverage, benefits and financial protection. Public health financing arrangements should provide continuity of coverage for all people throughout their lives to meet their health needs. But health financing policies that see projects as sustainable, rather than innovative, can lead to fragmentation and disruption. . Figure 1 highlights women’s working lives and women’s limited access to insurance, benefits and financial protection.
Unpaid care work is not always as important as paid work in work-based models. Some countries have separate programs for workers in the formal sector and their dependents, including spouses who do full-time unpaid care work. In Vietnam, dependents are not included in the national work force, but can enroll in a voluntary program, with fewer rights, which also offers to workers in the private sector.21 In Thailand, there are differences in insurance coverage and benefits. for plan dependents. The program for civil servants covers the maintenance of members’ parents, spouses, and up to two children.22 However, the program for private workers does not cover dependents. , which is included in the general population plan. 22
In these systems, recruitment or action in formal, informal and informal settings often alters the right to health care. In Mexico, for example, there are special health programs for formal and informal workers. More women than men in Mexico are unemployed, and often. Within a year women can move between formal and informal sectors and between work and unemployment.23 These changes
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