A Perspective on Health Inequities and the Need for Universal Healthcare

INTRODUCTION We don’t often think of health disparities as a theme unifying communities across the world, regardless of geography or level of economic development. Still, poor levels of health come as little surprise in the midst of endemic poverty, with 40% of the world living on less than $2 a day and great slices of African and Asian populations living on less than $1 a day (1,2). While the global perspective is that healthcare tends to be the province of the world’s richer countries, often the division between accessible healthcare in affluent, developed countries relative to poorer, developing countries is erroneously presumed. Even amongst wealthy nations, people’s human right to health and wellbeing, and specifically to medical care, is categorically denied (3,4). Some 45.8 million Americans, or 15.7% of the population, were uninsured in 2004, and this number continues to grow (5). It is this denial of people’s most basic human right, usually, but not necessarily alongside significant poverty, that links together diverse communities in developing and developed countries alike. Ultimately, these shared experiences of health inequity – either in the form of gaping health disparities in developed countries or inaccessible care in developing countries – point to the pervasive need for universal healthcare systems as one of the pillars to rectifying such injustices. As healthcare providers, bearing witness to these disparities has become routine. The dearth of universal access to care is evident in settings across the world, but all too often accepted in several medical spheres. During my own clerkship practicum as a medical student, I came face to face with these inequities working in clinics in rural Lake Atitlan, Guatemala and a part of inner-city Chicago I began to call the “Other Chicago,” the greatest reason being it’s inhabitants’ uneven access to healthcare services relative to other citywide demographics. Though these two communities were contextually different to an extreme, both were comprised of medically underserved and disenfranchised populations, where independently funded clinics responded to local healthcare needs by attempting to provide safety nets in areas without reliable access to care. However, an important distinction existed in terms of universal healthcare coverage: while the United States had no formal universal healthcare policy at the time, Guatemala had recently adopted such policy and it was slowly beginning to reach rural areas.