Читать книгу The Political Economy of the BRICS Countries - Группа авторов - Страница 87

The experiences of the four countries in improving access to health services in their countries towards universality offer valuable insights and lessons that India can learn from. In Table 5, we summarize the key points that emerged from the four-country (excluding India) analysis above.

The last column in Table 5 indicates that the two countries that have made substantial progress towards UHC are Brazil and China, with almost all the parameters showing positive results. While both the countries are struggling with concerns like shortage of physicians made worse by increasing NCDs, Brazil in particular has some way to go in raising the share of health in total government expenditure. Nevertheless, Brazil’s attempt at consolidation and pooling is commendable, because it uses general tax revenues to give similar services to all its population groups.

All the countries except India have a vision document for UHC, though Russia and South Africa have yet to translate all the stated objectives into action. Both Russia and South Africa could not implement all the administrative and legal reforms, and as a result these countries are struggling with complex and sticky issues of operational inefficiencies. Russia’s is a unique case because of its political economy legacy, but abrupt changes in policies and programs without proper groundwork have delayed and arrested progress towards UHC. As a result, Russia has been struggling with high OOPS. The only two countries with proper reforms and implementation are Brazil and China, despite the varied concerns with the current situation. The governance results indicate that with Brazil and China, Russia has also done well, and it may not be very difficult for it to turn things around with proper planning and foresight.