From the workshop "Universal Health Care: The First Step to Global Health Equity" held last August 5-9, 2012 in Mumbai, India during the 61st General Assembly March Meeting of the International Federation of Medical Students' Associations (IFMSA). Brought to you by the IFMSA Global Health Equity Initiative (http://www.ifmsa.org/Activities/Initiatives/The-IFMSA-Global-Health-Equity-Initiative). For more information about the workshop, visit http://www.scribd.com/doc/193822108/Universal-Health-Care-PreGA-Program

1. The International Political
Economy of Universal
Health Care
Ramon Lorenzo Luis R. Guinto, MD

2. Outline
• What is political economy?
• The global health system
• Exercise: Frames in global health
• Is the current political economy conducive
for UHC?

3. Political Economy
"aims to answer the question why policy-
makers adopt the policies they adopt" (Ooms,
et al. 2011)
“Why would countries participate in
global universal health coverage?”

4. Political Economy
"a body of analysis and a perspective on health
policy which seeks to understand the
conditions which shape population health and
health service development within the wider
macro economic and political context."
"seeks to understand the interplay between
politics and economics" (Legge, IPHU
website)

5. Political Economy: Linkages
• economic growth leads to increased resources for
health (improved living conditions and better health
services)
• health improvement contributes to economic growth
(improved labour productivity and decreased demand
for health expenditure)
• people's health is exchanged for economic growth
(mining 'accidents', unhealthy environments) and the
'disease burden' associated with these is the price of
economic growth

6. Political Economy: Linkages
• stagnation damages health (for example, where
unemployment, perhaps through the 'productivity
overhang', leads to negative health outcomes)
• winners and losers (distributional effects where the
competitive struggle for economic and political
advantage enhances the prospects of some but
diminishes the prospects for others)

7. The Global Health
System

9. From David Sanders, 2012

12. The Global Health
System and the
link to other
Sectors
From Julio Frenk, 2012

13. Sectors and Goals
From Julio Frenk, 2012

14. Frames in Global Health

20. Exercise: Frames in Global Health
Groupings:
1. Security perspective
2. Trade perspective
3. Human rights perspective
4. Development perspective
5. Global public goods perspective
6. Ethical/moral reasoning perspective

21. Exercise: Frames in Global Health
• What are the key principles governing the
assigned frame?
• How does the frame view its linkage with
health?
• Who are the global actors upholding,
pushing, and championing the frame?
• How does the frame apply to the issue of
universal health care?
• What would the framers propose as the key
to universal health care?

22. Exercise: Frames in Global Health
• Buzz groups discussion: 20 minutes
• Group presentations: 5 minutes each
• Open debate

23. Is the current
international political
economy conducive for
universal health care?