Health Governance (intro text)
the core of the debate is the fact that health is political and that
spaces for policy intervention exist at different levels. A governance
debate needs first to be based on the realisation that health cannot be
addressed without a real involvement of people and their organisations
at all the levels, and that it is essential to have an open debate
about the values attached to health.
We enter an historical phase of
health interdependence with the joint recognition of health as global
public good and of the fact that "no individual or nation state can
fully guarantee its own health" (Kaul et al., 1999:297) thus
cooperation among nations becomes mandatory.
In these times of excessive wealth creation and accumulation, and when
it costs about $30-$40 per capita to provide basic healthcare coverage
in a low-income country, access to health care becomes a very
contentious political issue. The solutions become clear and sustainable
if seen from a perspective of redistributive justice. And in that
context it would seem appropriate to gradually shift to social
health-insurance systems, which operate on the bases of solidarity
contributions among high-income and low-income groups. This would be
the main source for financing universal health access.
As different interventions are proposed, the importance of the state and the public sector becomes essential, calling in fact for a reliable and accountable mechanism for global governance and a strengthened public sector at all levels.