Universal health coverage: The strange romance of The Lancet, MEDICC, and Cuba

Abstract

As a key supporter of universal health coverage (UHC), The Lancet recently partnered with Medical Education Cooperation with Cuba (MEDICC), a non-governmental organization based in the United States, to produce a Spanish-language translation of The Lancet’s series on UHC in Latin America. This translation was launched as part of CubaSalud 2015, an international health conference held during April 2015 in Havana, Cuba. Despite its often ambiguous definition, UHC usually refers to a financial reform extending insurance coverage in varying degrees to a larger part of a country’s population. UHC does not mean “healthcare for all” (HCA) – a healthcare delivery system that provides equal services for the entire population regardless of an individual’s or family’s financial resources. UHC has received wide criticism because it does not necessarily create a unified, accessible system; because it usually encourages a role for private, for-profit insurance corporations; and because it in-volves tiered benefits packages with differing bene-fits for the poor and non-poor. Although the UHC orientation has become “hegemonic” in global health policy circles, its ideological assumptions have not been confirmed empirically. The editors of The Lancet and MEDICC Review should explain more fully the decisions to translate the UHC series and to launch the translation in Havana, and they should provide “equal time” for critiques of UHC and presentations of endeavors to achieve HCA