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In recent years the international debate about universality in health has been marked by a polarization between ideas based on a universal system, and notions proposing universal health coverage. The concept of universal coverage has been disseminated by international organizations and has been incorporated into health system reforms in several developing countries, including some in Latin America. This article explores the assumptions and strategies related to the proposal of universal health coverage. Firstly, a comparison is provided of the models of universal health coverage and universal health systems. This is followed by a contextualization of the international debate, including examples of different health systems. Finally, the implications of the proposal of universal coverage for the right to health in Brazil are discussed. The analysis of different concepts of universality and the experiences of different countries shows that health insurance-based models, either social or private, are not as satisfactory as public, universal health systems. Greater understanding about ongoing international projects is essential in order to identify the possibilities represented by the consolidation of the Unified Health System (SUS) in Brazil, as well as the risks of dismantling the SUS.
This article was published in the following journal.
Name: Ciencia & saude coletiva
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Health insurance coverage for all persons in a state or country, rather than for some subset of the population. It may extend to the unemployed as well as to the employed; to aliens as well as to citizens; for pre-existing conditions as well as for current illnesses; for mental as well as for physical conditions.
Innovation and improvement of the health care system by reappraisal, amendment of services, and removal of faults and abuses in providing and distributing health services to patients. It includes a re-alignment of health services and health insurance to maximum demographic elements (the unemployed, indigent, uninsured, elderly, inner cities, rural areas) with reference to coverage, hospitalization, pricing and cost containment, insurers' and employers' costs, pre-existing medical conditions, prescribed drugs, equipment, and services.
Insurance coverage of a physical or mental health condition, disability, or illness existing before health insurance is applied for or enrolled in.
Public Law 104-91, enacted in 1996, is designed to protect health insurance coverage for workers and their families when they change or lose their jobs. HIPAA has separate provisions for the large and small group markets, and the individual market. HIPAA amends the Employee Retirement Income Security Act (ERISA), the Public Health Service Act, and the Internal Revenue Code to provide improved portability and continuity of health insurance coverage, extending earlier provisions under the Consolidated Omnibus Budget Reconciliation Act of 1985 ("COBRA").
The process of helping patients to effectively and efficiently use the health care system when faced with one or more of these challenges: (1) choosing, understanding, and using health coverage or applying for assistance when uninsured; (2) choosing, using, and understanding different types of health providers and services; (3) making treatment decisions; and (4) managing care received by multiple providers.