Universal health coverage, or “UHC”, is much talked about these days. There’s a lot of technical analysis about how best to achieve it — should it funded out of the national tax base or out of pooled premia? How much should people pay out of their own pockets? Does task-shifting between differently trained health workers increase reach or affect outcomes? Many such questions are asked, but there’s less work examining in detail the political processes that affect the desirability or feasibility of each of these options.

Working with colleagues at Migunani Research Institute in Yogyakarta and Erasmus University in Rotterdam, we’ve tried to look at the political economy of health insurance in Indonesia, and its evolution over the last seven decades.

We’ve also been investigating the way under-resourced scale-up of public health provision can create perverse incentives for organisations that provide medicines and health services. One potential consequence is an increase in fake and poor quality medicines on national markets.