In the previous article I discussed the types of public health systems. This article will discuss the objectives of health systems.

Objectives of Health Systems

Over time there has been a change in health needs of populations. Growing awareness of one’s rights, and the spread of democracy have raised people’s expectations regarding health. Today, people expect access to health care in some form, and increasingly demand for measures to protect sick (and their families) against the financial costs of ill-health. Awareness of the impact on health of industrialization, environmental damage, road transport, and globalization has broadened the sphere of activity of health systems.

How the system treats people’s health needs, including how much protection it offers them from financial risk, and responds to their expectations are important. To the extent possible, people’s needs should be promptly addressed- to respect their time and reduce anxiety, as well as for better health outcomes.

Thus, the objectives of health systems are:

• Improving the health of the population they serve
• Responding to people’s expectations
• Providing financial protection against the costs of ill-health

Unfortunately, these objectives are not always met, and results in widespread public dissatisfaction with the way health services are run or financed.

Improving Health

Health is the defining objective for a health system. This means making the health status of the entire population as good as possible over people’s entire life cycle, taking account of both premature mortality and disability. Unfortunately, there is no single measure of health that can accurately encapsulate the health of a population. Life expectancy is one measure that is available for most countries. Inequalities in health are often reflected in differences in life expectancy. In a fair health system

If everyone had the same life expectancy, adjusted for disability, the system would be perfectly fair with respect to health, even though people would actually die at different ages.

This means that after one made adjustments to life-expectancy estimates based on prevailing disability rates, in a perfectly fair health system all people would have the same life-expectancy. (The occurrence of disability implies that those with disability would have poorer life-expectancy. Mathematically adjusting for this should yield life-expectancy estimates that are uniform for all people- if they are beneficiaries of a perfectly fair health system.)