ABSTRACT
Universal health coverage (UHC) is the leading slogan in global health policy today. The outcomes promised by the slogan – access to essential healthcare and protection from catastrophic healthcare costs – are admirable. However, an exploration of the implementation pathways prefigured in the policy narrative reveals unacknowledged contradictions and silences, which, in turn, cast doubt on the promises. This chapter reviews the UHC narrative within two frames: first, a health systems perspective, focused on the financing of ‘beyond-the-package’ services, and second, a political economy analysis centered on the points of articulation between global health and the political economy of global capitalism. The chapter concludes that, notwithstanding the official rhetoric, current policy directions point to an agenda fostering the irreversible installation of marketized, privatized, multi-tiered healthcare.
