Democracies linked to greater universal health coverage compared with autocracies, even in an economic recession

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buir.contributor.authorWigley, Simon
buir.contributor.orcidWigley, Simon|0000-0001-9181-0129
dc.citation.epage1242en_US
dc.citation.issueNumber8en_US
dc.citation.spage1234en_US
dc.citation.volumeNumber40en_US
dc.contributor.authorTemplin, T.
dc.contributor.authorDieleman, J. L.
dc.contributor.authorWigley, Simon
dc.contributor.authorMumford, J. E.
dc.contributor.authorMiller-Petrie, M.
dc.contributor.authorKiernan, S.
dc.contributor.authorBollyky, T. J.
dc.date.accessioned2022-02-22T08:33:48Z
dc.date.available2022-02-22T08:33:48Z
dc.date.issued2021-08
dc.departmentDepartment of Philosophyen_US
dc.description.abstractDespite widespread recognition that universal health coverage is a political choice, the roles that a country’s political system plays in ensuring essential health services and minimizing financial risk remain poorly understood. Identifying the political determinants of universal health coverage is important for continued progress, and understanding the roles of political systems is particularly valuable in a global economic recession, which tests the continued commitment of nations to protecting their health of its citizens and to shielding them from financial risk. We measured the associations that democracy has with universal health coverage and government health spending in 170 countries during the period 1990–2019. We assessed how economic recessions affect those associations (using synthetic control methods) and the mechanisms connecting democracy with government health spending and universal health coverage (using machine learning methods). Our results show that democracy is positively associated with universal health coverage and government health spending and that this association is greatest for low-income countries. Free and fair elections were the mechanism primarily responsible for those positive associations. Democracies are more likely than autocracies to maintain universal health coverage, even amid economic recessions, when access to affordable, effective health services matters most.en_US
dc.identifier.doi10.1377/hlthaff.2021.00229en_US
dc.identifier.issn0278-2715
dc.identifier.urihttp://hdl.handle.net/11693/77548
dc.language.isoEnglishen_US
dc.publisherProject HOPEen_US
dc.relation.isversionofhttps://doi.org/10.1377/hlthaff.2021.00229en_US
dc.source.titleHealth Affairsen_US
dc.subjectUniversal coverageen_US
dc.subjectCost and spendingen_US
dc.subjectQuality of careen_US
dc.subjectAccess to careen_US
dc.subjectDiseaseen_US
dc.subjectHealth serviceen_US
dc.subjectPandemicsen_US
dc.subjectMortalityen_US
dc.subjectPoliticsen_US
dc.subjectNational health systemsen_US
dc.subjectCOVID-19en_US
dc.titleDemocracies linked to greater universal health coverage compared with autocracies, even in an economic recessionen_US
dc.typeArticleen_US

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