Panama Model United Nations 2023| XXXI Annual Session

Forum: World Health Organization (WHO)

Issue #1: Measures to address the financial burden of healthcare and its

negative impact on individuals.

Student Officers: Seoyun Bae and Daniel Petrosky

Position: Chair of the World Health Organization (WHO)

Introduction

Healthcare is a vital part of society that ensures the well-being of individuals. It

comes in various forms, ranging from regular check-ups to life-saving operations.

As healthcare systems differ among countries around the globe, accessibility

and affordability of healthcare vary as well. This gives rise to a number of issues

surrounding healthcare, among which is the financial strain created by medical

costs. Unfortunately, healthcare costs still cause a burden for many people

today in the 21st century across the globe. In 2019, 996 million people, which

equates to 13.2% of the world’s population, spent “more than 10% of their

household budget on health care out-of-pocket,” and 1.1 billion people were

pushed further into poverty due to the financial burdens of health care (“Global

monitoring”).

Situations that require medical care often rise unpredictably, and for many low-

income families, these situations result in having to pool from their life savings or

selling their assets. This could destroy their futures, as well as those of their

children (“Universal Health”, WHO). The financial burden of healthcare does not

Research Report | Page 1 of 23

 Panama Model United Nations 2023| XXXI Annual Session

only affect those impacted by unexpected illnesses, but also those who avoid

receiving medical care in fear of the costs. Many individuals receive delayed

medical care, which often increases the morbidity and mortal risk of the illness,

often for chronic illnesses such as diabetes and heart disease due to the

anticipated medical bills. To illustrate, in 2022 in the United States, 38% of the

population reported having delayed their treatment due to costs (Nova).

Therefore, it is critical for governments to take action to make healthcare more

affordable for their citizens. This may come in the form of establishing universal

healthcare, price-capping, and public-private partnerships. When governments

are making decisions on these policies, they must consider the resources they

have available and the areas that require assistance.

Definition of Key Terms

Financial Burden of Healthcare

The financial burden of health healthcare involves expenses concerning

treatment, medications, and overall access to quality healthcare services.

Access to Healthcare

Healthcare is an essential service to all human beings

Universal Health Coverage (UHC)

Full access to essential top-tier quality healthcare services without regarding

economic status.

Quality Healthcare

Healthcare requires effective, safe, equitable, and people centered care, to be

considered quality healthcare.

Research Report | Page 2 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Insurance

Insurance is a contract between an insurance company and a person

(policyholder). The policyholder pays a premium to the insurance company,

and the insurance company promises to cover all or part of the costs involving

healthcare, damages or losses.

Taxes

Taxes are mandatory contributions imposed by state and local governments,

used to improve infrastructure, education, and in some cases, healthcare.

Primary Health Care (PHC)

Primary Healthcare makes up the foundation of a strong healthcare system, it

aims to provide top-notch equitable healthcare, by focusing on treatment such

as rehabilitation, palliative care, pediatric care, to also disease prevention, and

the promotion of healthy lifestyles.

Catastrophic Health Expenditure

Catastrophic Health Expenditure refers to the financial burden caused to a

person or household due to a sudden, essential and out-of-pocket expenditure

on healthcare. It is defined as spending 10% or more on healthcare-related

expenses.

Palliative Care

Palliative care involves particular care to people facing serious, life-threatening

illnesses, such as cancer, heart disease, kidney failure, and more, who require

more attention, frequent and intensive care.

Financial Protection

Research Report | Page 3 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Financial Protection is a policy that guarantees that no financial hardships are

incurred. It is achieved by prepayment, and fund pooling in order to prevent

out-of-pocket expenditures, and sudden catastrophic financial repercussions.

Out-of-Pocket (OOP) Expenditures

Out-of-pocket expenditures occur when payment from a person or household’s

income or savings is made in regard to healthcare goods and or services.

Price Capping

Price capping is a government-imposed and enforced limit on the price

charged for medicines and essential treatments.

General Overview

Burdens Associated with High Healthcare Costs

The continuous rise in healthcare-related costs has caused severe repercussions

for humans around the world. The rise in costs involves medications, essential

care access to quality treatment, and doctors. For Individuals and families that

face financial hardships, the magnitude of rising healthcare costs implies severe

repercussions in regard to health or finance. According to Value Penguin, an

insurance policy comparison site, the price hikes in products and services in

2022, are expected to elevate insurance policy prices in 2023, which further

raises the possibility of financial burdens caused by healthcare in the United

States (Merelli).

Universal healthcare provides an effective solution to the problem, by removing

the financial hardships of healthcare, such as treatment, rehabilitation, palliative

Research Report | Page 4 of 23

 Panama Model United Nations 2023| XXXI Annual Session

care, and any essential clinical necessity. It is important to emphasize that

countries with strong universal healthcare systems require their citizens to pay

higher amounts of money in taxes, some countries using universal healthcare

have personal income taxes of up to 53% (World Population Review). While

universal healthcare provides a strong and promising solution to many countries,

a tradeoff has to be made in regard to sustaining this system.

Benefits of Universal Healthcare and its Impact on Societies

As aforementioned, universal healthcare provides and has provided a promising

solution to alleviate the burdens associated with healthcare expenditure and

overall costs. By offering a full range of quality healthcare, with little to no

associated costs, communities and societies are positively impacted by UHC as

the system improves the overall quality of life, and promotes good health and

wellbeing. The people-centered, and equitable policies of universal healthcare,

further elevate health standards within a country, as citizens will opt to obtain

preventative care, and early detection of illnesses, this not only helps the

individual, it affects societies, as it helps prevent the spread of illness, increases

productivity and promotes a more equal and just society. The system also

influences and supplements the growth of public health infrastructure, as it helps

maintain the population healthy, and is more equipped to prevent outbreaks

and the spread of illnesses. Overall, UHC promises meaningful results that

positively impact the quality of life, health infrastructure, and response of

healthcare systems around the globe, by promoting good health, treatment,

and early detection, with no financial burdens on individuals and societies

(“Public Health”).

Research Report | Page 5 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Major Parties Involved and Their Views

Japan

Japan is among the nations that have established a universal health coverage

system in an effort to make medical care more accessible and affordable for its

citizens. All of Japan’s population is covered by a mandatory coverage called

the Statutory Health Insurance System (SHIS), which covers 98.3% of the

population, or the Public Social Assistance Program, which covers the remaining

1.7% which consist of impoverished individuals. Nearly all aspects of this system

are regulated by the government, including the fee schedule, which controls

many aspects of health care, such as the prices, nurse staffing levels, diagnosis

criteria for procedures, among others (“Universal…Lessons from Japan”). Other

than the SHIS, the Japanese government provides subsidies to local

governments, insurance companies, and healthcare providers. Thanks to this

well-established system, in 2015, only 14% of all health expenditures were made

out-of pocket, and 84% were publicly financed. Japan also has various

regulations that form a financial safety net for its citizens. For instance, even

though citizens pay 30% coinsurance for most services, there is an annual

household health cost ceiling, above which all payments are reimbursed by the

government (Tikkanen et al., “Japan”).

France

France has a statutory health insurance system (SHI) that all citizens are

obligated to enroll in that ensures universal health coverage in the nation. It was

first created in 1945 and was opened to all employed and retired citizens. Later

in 1966, it was extended to the self-employed, and finally, in the year 2000, it was

Research Report | Page 6 of 23

 Panama Model United Nations 2023| XXXI Annual Session

further extended to unemployed citizens as well. Apart from the SHI, there is a

Universal Health Coverage (CMU) system that covers citizens not eligible for the

SHI. Through a combination of these two systems, France has been able to

achieve nearly 100% coverage. The system is funded majorly by payroll taxes

(taxes paid by employers and employees), and it covers payments for the

majority of hospital, physician, and prescription medication bills (“France Health

''). However, patients are still responsible for coinsurance and copayments for

costs that exceed the coverage. France’s system has proven to be effective, as

in 2015, only 7% of all healthcare expenditures were out-of-pocket, and 77%

were publicly financed (Tikkanen et al., “France'').

China

China is approaching universal health coverage through the creation of three

public insurance programs: the Urban Employee Basic Medical Insurance, the

Newly Cooperative Medical Scheme, and the Urban Resident Medical

Insurance. Only the Urban Employee Basic Medical Insurance is mandatory, and

it is only available for employed urban residents. However, the other two

programs attempt to expand healthcare coverage to rural and unemployed

urban residents. China’s efforts have led to progress, and in 2011, approximately

95% of the country’s population was insured (Shimizu). Despite this, OOP

spending still make up approximately 28% of all healthcare expenditures, and

this can be largely attributed to the lack of a ceiling on annual OOP spending.

Moreover, both inpatient and outpatient care can have copayments and

deductibles, which can contribute to OOP spending (Tikkanen et al., “China'';

Tao et al.). China has also made efforts to make drugs more affordable for its

citizens. The government has taken aggressive actions in lowering drug prices

Research Report | Page 7 of 23

 Panama Model United Nations 2023| XXXI Annual Session

and setting price ceilings. For example, in early 2018, 36 drugs were made

significantly cheaper through negotiations between the Chinese government

and pharmaceutical companies (Lo).

United States

The United States has a healthcare system that is composed of a mix of public

and private insurance companies and healthcare providers. However, the

private sector is predominant in the US, due to the lack of universal health

coverage. It is currently the only developed country that lacks such a system,

and consequently, in 2021, 8.6% of the population (which is equivalent to 27.5

million citizens) were uninsured, which is a comparably higher portion of the

population than other developed nations (Howard). The majority of US citizens

(approximately 55%) receive insurance from their employers, and the coverage

of public insurance programs, such Medicare and Medicaid, are limited. For

instance, Medicaid only provides insurance for 17.9% of the nation’s citizens.

Moreover, only 28% of all healthcare expenditures in 2017 was represented by

federal spending. This left individuals to carry the burden of 10% of all

expenditures in the form of OOP payments (Tikkanen et al., “United States”). As

a result of this flawed healthcare system, residents of the US visit doctors

significantly less frequently than other countries, which contributes to poorer

healthcare outcomes, despite the immense amount of money spent on

healthcare (Howard). Moreover, the United States lacks direct regulation of the

prices of pharmaceuticals. This can be largely attributed to Medicare’s inability

to negotiate with companies on a federal level (Lo).

India

Research Report | Page 8 of 23

 Panama Model United Nations 2023| XXXI Annual Session

India has been making efforts to make healthcare more affordable for its

citizens by implementing a number of programs. However, they have not been

very successful. For instance, in 2008, the National Health Insurance Program

(RSBY) was created for low-income families, but evaluations of the program

have shown that it has not significantly reduced OOP spending, likely due to its

exclusion of outpatient, primary, and tertiary care (Kamath; Tikkanen et al.,

“India”). Additionally, even though all citizens are eligible for free inpatient and

outpatient care at all government hospitals, many are not able to receive

treatment due to shortages of staff and supplies at these facilities. The most

recent attempt at improving public healthcare in India has been the National

Health Protection Scheme (PM-JAY), a tax-financed initiative launched in 2018

that aims to provide coverage for 40% of the country’s poorest population

(approximately 100 million families). The result of such a defective healthcare

system has been devastating, with only 37% of the population covered by

insurance, leaving 63% vulnerable to financial catastrophe and large OOP

spending. In fact, in 2015-2016, 65% of all healthcare expenditures came from

OOP payments (Tikkanen et al., “India”). However, India is known for its strong

regulations on medicine prices. It has imposed price ceilings on many essential

pharmaceutics, and it is one of the world’s leading providers of economical

medication (Lo).

Timeline of Events

Date Description of event

1883 Germany’s Chancellor Otto von Bismarck established the world’s

first national health insurance program through the Health

Research Report | Page 9 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Insurance Act (Tikkanen et al., “Germany”).

Japan established its Employees’ Health Insurance Law, the first

among Asian nations. Japan further expanded on this health

1922
insurance system later on to achieve the SHIS system that it has

now (Shimazaki).

The United Kingdom launched its National Health Service (NHS),

July 5, 1948 which was the first universal healthcare system that truly covered

the entire population in Western society (Delamothe).

134 nations came together in Almaty, Kazakhstan to create the

September 1978 Alma Ata Declaration, which emphasized the importance of

primary health care for health equity (“WHO Called”).

The UN’s constitution acknowledged the importance of health,

June 26, 1946 stating that “health is one of the fundamental rights of every

human being” (“United Nations Charter”).

The International Health Partnership (IHP+) was established with the

goal of enhancing collaboration between nations to more

September 2007
effectively reach the Millennium Development Goals. It was later

changed into UHC2030 in 2016 (“History”).

The World Bank began its Universal Health Coverage Study Series,

2013 which has covered the universal health coverage systems of 40

different countries (“Universal Health”, World Bank).

September 25, The Sustainable Development Goals were adopted by the UN

2015 General Assembly (“A History”). Goal 3.8 focuses on achieving

Research Report | Page 10 of 23

 Panama Model United Nations 2023| XXXI Annual Session

universal health coverage, which includes protection against

catastrophic health expenditures and increasing accessibility and

affordability of medical care (“Universal Health”, WHO).

The UN passed a resolution that encouraged member states to

establish dialogues with various stakeholders to “maximize their

December 12,
engagement in and contribution to the implementation of health
2017
goals.” This day was proclaimed International UHC Day (“A

History”).

World leaders met again in Astana, Kazakhstan to pledge to the

October 2018
Astana Declaration on Primary Health Care (“Declaration”).

COVID-19 gravely impacted many nations, and 92% of nations

March 2020 reported disruptions to essential healthcare services (“Universal

Health”, WHO).

UN involvement, Relevant Resolutions, Treaties and Events

The UN estimates that up to 60 million lives can be saved per year by upping

annual spending on primary healthcare especially in low to middle income

countries. An important effort was made in December 2021 to develop a treaty

to strengthen pandemic prevention, preparedness and response on behalf of

the World Health Assembly. Japan expressed its commitment to UHC at the G7

Ise-Shima Summit and G7 Kobe Health Ministers' Meeting held in 2016 (Kutty and

Tochibayashi). With countries increasing universal healthcare coverage, aiming

to alleviate all healthcare associated financial burdens, for instance all G7

countries besides the United States, offer top-notch universal healthcare to

Research Report | Page 11 of 23

 Panama Model United Nations 2023| XXXI Annual Session

almost all of their citizens.

Evaluation of Previous Attempts to Resolve the Issue

Many countries have worked on implementing universal healthcare coverage

systems, and many significant steps were taken by different nations to expand

financial protection for more individuals. A review by the World Bank has

concluded that this intervention has improved healthcare access and financial

protection in low- and middle-income countries. Nonetheless, the magnitude of

the effect that universal healthcare coverage policies had in different nations

varied depending on the context, the design of the policy, and the

implementation of it as well (Giedion et al.). Moreover, a study from 2020

estimated that 3.1 billion people will not be protected by effective healthcare

coverage, with nearly 1 billion of these individuals residing in South Asia. This

signifies that the world will be failing to achieve WHO’s goals that were set for

between 2019 and 2023 (“New Evaluation”).

Other than universal healthcare coverage, governments have attempted to

make healthcare more affordable by implementing price caps (also known as

price ceilings) on pharmaceutical goods. Although these policies were a direct

and effective intervention in reducing the financial burden of healthcare, it has

also been met with criticism from pharmaceutical companies (Synnott et al.).

For instance, Pfizer has explained how such policies may “undercut innovation

and stall the development of groundbreaking medicines” and also limit

patients’ access to life-saving medications (“Price Controls”). Therefore, it is

crucial to develop a policy that makes pharmaceuticals more economical

while minimizing the repercussions for pharmaceutical firms.

Research Report | Page 12 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Possible Solutions

Different funding systems (tax-funded or combination of private and public

funding)

Taxes are an essential part of a healthcare system, especially when

considering and implementing universal healthcare, taxes are a way to

pool funds and increase budgets diverted toward healthcare projects.

The pooling of private funds to sponsor healthcare is also a valid solution,

by pooling funds in advance the risk of a financial disaster caused by out-

of-pocket expenditures is lowered or eliminated.

Price capping on essential prescription medications and essential treatments by

using taxes, govt subsidies, etc…

In the last decades many medications such as insulin have faced strong

inclines in prices, according to the NPR insulin prices rose up to 600% in the

last 20 years (Inskeep and Aubrey), however some pharmaceutical

manufacturers have price capped insulin to alleviate the monstrous rising

costs for the 150-200 million estimated people who depend on insulin

globally, this policy does not only apply to insulin, it could apply to all

essential medications globally.

Government subsidies to sponsor strong healthcare infrastructure

Strong healthcare infrastructure is a very important factor in alleviating or

eliminating the financial burden of increased healthcare costs, for

instance, countries with government subsidized healthcare systems have

faced success in implementing not only approachable healthcare, by

having more quantities of affordable medications and treatments, but

Research Report | Page 13 of 23

 Panama Model United Nations 2023| XXXI Annual Session

even in implementing universal health care as a whole.

Encourage early disease detection and prevention

A significant amount of people suffer with diseases that if detected earlier,

the treatment would have been less harsh on the body, easier to treat,

and finally more affordable, this policy promotes healthy lifestyles and is

yet to be introduced in many countries around the world, as this policy

helps the people, and also reduces strain on healthcare systems globally.

Address and target fraud and corruption in healthcare systems

Unfortunately with many positives, come negatives, and healthcare fraud

can unfortunately be one of the negatives. According to the FBI,

healthcare fraud accounts for billions of dollars in losses, which

subsequently increases healthcare costs, regarding insurance, exposure

to out-of-pocket expenditures, and other repercussions (“Health Care

Fraud”). By targeting and addressing fraud and corruption, transparency

allows for these repercussions to be alleviated, and for healthcare systems

to be safer, and more efficient.

Supplement competition in pharmaceuticals for companies to offer more

competitive (lower) prices

Competition in the healthcare industry can have unseen benefits, such as

more competitive prices which provides people the advantage to

acquire medications and treatments at a somewhat lower cost.

Government intervention in supplementing competition allows for these

prices to drop even more.

Research Report | Page 14 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Sustainable Development Goal (SDGs)

The issue of making healthcare affordable is strongly linked to the first

Sustainable Development Goal, which is “Ending poverty in all its forms

everywhere”. By creating new measures to reduce the costs of medical care,

the number of individuals forced into poverty will decrease, as the overall

burden and out-of-pocket costs will be reduced as well. Thus, creating measures

that address the issue at hand will help to end poverty in nations.

Research Report | Page 15 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Bibliography

“Declaration of Astana.” Global Conference on Primary Health Care , World

Health Organization, 2018,

https://www.who.int/docs/default-source/primary-health/declaration/

gcphc-declaration.pdf.

Delamothe, Tony. “Founding Principles.” BMJ, vol. 336, no. 7655, 2008, pp. 1216–

1218., https://doi.org/10.1136/bmj.39582.501192.94.

“France Health System Information.” European Observatory on Health Systems

and Policies, European Observatory on Health Systems and Policies, 2015,

https://eurohealthobservatory.who.int/countries/france.

Giedion, Ursula, et al. “The Impact of Universal Coverage Schemes in the

Developing World: A Review of the Existing Evidence.” The World Bank,

The World Bank, Jan. 2013,

https://documents1.worldbank.org/curated/en/349621468158382497/pdf/

753260NWP0Box30ewofExistingEvidence.pdf.

“Global Monitoring Report on Financial Protection in Health 2019.” World Health

Organization, World Health Organization, 13 Apr. 2020,

https://www.who.int/publications/i/item/global-monitoring-report-on-

financial-protection-in-health-2019.

“Health Care Fraud.” FBI, FBI, 1 June 2016,

https://www.fbi.gov/investigate/white-collar-crime/health-care-fraud.

“History - UHC2030.” UHC2030, UHC2030,

Research Report | Page 16 of 23

 Panama Model United Nations 2023| XXXI Annual Session

https://www.uhc2030.org/about-us/history/.

“A History of Universal Health Coverage in the UN.” UHC2030, UHC2030,

https://www.uhc2030.org/un-hlm-2019/a-history-of-universal-health-

coverage-in-the-un/.

Howard, Jacqueline. “US Spends Most on Health Care but Has Worst Health

Outcomes among High-Income Countries, New Report Finds.” CNN,

Cable News Network, 31 Jan. 2023,

https://edition.cnn.com/2023/01/31/health/us-health-care-spending-

global-perspective/index.html.

Inskeep, Steve, and Allison Aubrey. “Insulin Costs Increased 600% over the Last 20

Years. States Aim to Curb the Price.” NPR, NPR, 12 Sept. 2022,

https://www.npr.org/2022/09/12/1122311443/insulin-costs-increased-600-

over-the-last-20-years-states-aim-to-curb-the-price#:~:text=Insulin%20costs

%20increased%20600%25%20over,to%20curb%20the%20price%20%3A

%20NPR&text=Press-,Insulin%20costs%20increased%20600%25%20over

%20the%20last%2020%20years.,of%20skyrocketing%20costs%20of%20insulin.

Kamath, Sagarika, and Rajesh Kamath. “Shortcomings in India’s First National

Attempt at Universal Healthcare through Publicly Funded Health

Insurance.” Postgraduate Medical Journal, vol. 96, no. 1138, 16 Apr. 2020,

pp. 449–450., https://doi.org/10.1136/postgradmedj-2020-137760.

Kutty, Naoko, and Naoko Tochibayashi. “Mainstreaming Universal Health, with

Japan at the Helm as a Long-Lived Nation.” World Economic Forum, 21

Dec. 2022, https://www.weforum.org/agenda/2022/12/mainstreaming-

Research Report | Page 17 of 23

 Panama Model United Nations 2023| XXXI Annual Session

universal-health-coverage-with-japan-at-the-helm-as-a-leading-health-

nation/#:~:text=Government%20leaders%20from%20over%2030,to

%20achieve%20UHC%20by%202030.

Lo, Chris. “Cost Control: Drug Pricing Policies around the World.” Pharmaceutical

Technology, Pharmaceutical Technology, 12 Feb. 2018,

https://www.pharmaceutical-technology.com/features/cost-control-

drug-pricing-policies-around-world/.

Merelli, Annalisa. “Health Insurance Rates Will Rise Faster in 2023 in These US

States.” Quartz, Quartz, 19 Dec. 2022, https://qz.com/health-insurance-

rates-will-rise-faster-in-2023-in-thes-1849910939#:~:text=On%20average

%2C%20individuals%20buying%20insurance,and%20New%20Mexico%20by

%2015%25.

“New Evaluation of Universal Health Coverage Shows That the World Will Likely

Fall Short of World Health Organization Goal.” Institute for Health Metrics

and Evaluation, Institute for Health Metrics and Evaluation, 22 Aug. 2021,

https://www.healthdata.org/news-release/new-evaluation-universal-

health-coverage-shows-world-will-likely-fall-short-world.

Nova, Annie. “Record High Share in U.S. Report Delaying Medical Treatments

Due to Costs - Here's How You Can Save on Health Care.” CNBC, CNBC,

20 Jan. 2023, https://www.cnbc.com/2023/01/20/americans-put-off-

health-care-because-of-cost-how-you-can-save.html.

“Price Controls Could Limit Patient Access to Lifesaving Medications.” Pfizer,

Pfizer,

Research Report | Page 18 of 23

 Panama Model United Nations 2023| XXXI Annual Session

https://www.pfizer.com/responsibility/ready-for-cures/price_controls_coul

d_limit_patient_access_to_lifesaving_medications.

“Public Health Infrastructure.” Healthy People 2030, US Department of Health

and Human Services, https://health.gov/healthypeople/objectives-and-

data/browse-objectives/public-health-infrastructure#:~:text=Public

%20health%20infrastructure%20provides%20the,a%20strong%20public

%20health%20infrastructure.

Shimazaki, Kenji. “The Path to Universal Health Coverage – Experiences and

Lessons from Japan for Policy Actions.” Japan International Cooperation

Agency, June 2013.

Shimizu, Yoshi. “Health Financing in China.” World Health Organization, World

Health Organization, https://www.who.int/china/health-topics/health-

financing.

Synnott, Patricia G., et al. “A Value-Based Approach to America's Costly

Prescription Drug Problem.” The Commonwealth Fund, The

Commonwealth Fund, 6 May 2022,

https://www.commonwealthfund.org/blog/2022/value-based-approach-

americas-costly-prescription-drug-problem.

Tao, Wenjuan, et al. “Towards Universal Health Coverage: Achievements and

Challenges of 10 Years of Healthcare Reform in China.” BMJ Global

Health, vol. 5, no. 3, 2020, https://doi.org/10.1136/bmjgh-2019-002087.

Tikkanen, Roosa, et al. “China.” The Commonwealth Fund, The Commonwealth

Fund, 5 June 2020, https://www.commonwealthfund.org/international-

Research Report | Page 19 of 23

 Panama Model United Nations 2023| XXXI Annual Session

health-policy-center/countries/china.

Tikkanen, Roosa, et al. “France.” The Commonwealth Fund, The Commonwealth

Fund, 5 June 2020, https://www.commonwealthfund.org/international-

health-policy-center/countries/france.

Tikkanen, Roosa, et al. “Germany.” The Commonwealth Fund, The

Commonwealth Fund, 5 June 2020,

https://www.commonwealthfund.org/international-health-policy-center/

countries/germany.

Tikkanen, Roosa, et al. India, The Commonwealth Fund, 5 June 2020,

https://www.commonwealthfund.org/international-health-policy-center/

countries/india.

Tikkanen, Roosa, et al. “Japan - International Health Care System Profiles.” The

Commonwealth Fund, The Commonwealth Fund, 5 June 2020,

https://www.commonwealthfund.org/international-health-policy-center/

countries/japan.

Tikkanen, Roosa, et al. United States, The Commonwealth Fund, 5 June 2020,

https://www.commonwealthfund.org/international-health-policy-center/

countries/united-states.

“United Nations Charter (Full Text).” United Nations, United Nations,

https://www.un.org/en/about-us/un-charter/full-text.

“Universal Health Coverage (UHC).” World Health Organization, World Health

Organization, 12 Dec. 2022, https://www.who.int/news-room/fact-

Research Report | Page 20 of 23

 Panama Model United Nations 2023| XXXI Annual Session

sheets/detail/universal-health-coverage-(uhc).

“Universal Health Coverage for Inclusive and Sustainable Development: Lessons

from Japan.” Universal Health Coverage for Inclusive and Sustainable

Development, 2014, https://doi.org/10.1596/978-1-4648-0408-3.

“Universal Health Coverage Study Series (UNICO).” World Bank, World Bank

Group, 30 Jan. 2018,

https://www.worldbank.org/en/topic/health/publication/universal-health-

coverage-study-series.

“WHO Called to Return to the Declaration of Alma-Ata.” World Health

Organization, World Health Organization,

https://www.who.int/teams/social-determinants-of-health/declaration-of-

alma-ata.

World Population Review. “Highest Taxed Countries 2023.” World Population

Review, World Population Review, 2023,

https://worldpopulationreview.com/country-rankings/highest-taxed-

countries.

Appendix

I.

A. This diagram from the Kaiser Family foundation shows the predicted

increase in out of pocket expenditures on healthcare of families

with an income of $10,000 or less per year, it is highly significant

because it represents the continuous rising costs of healthcare wich

Research Report | Page 21 of 23

 Panama Model United Nations 2023| XXXI Annual Session

directly affects the catastrophic effects of out-of-pocket

expenditures. The Kaiser Family Foundation is a San Francisco based

non-profit organization which focuses on healthcare policies, it is

considered to be one of the most accurate and unbiased sources

when investigating healthcare.

II. #2

A. This diagram is a visual representation of countries with guaranteed

universal healthcare coverage around the world.

III. Source #3: Intuit Mint Life

Research Report | Page 22 of 23

 Panama Model United Nations 2023| XXXI Annual Session

Understanding the pros and cons of universal healthcare is essential when

researching why certain countries are able to offer the system, while others

can’t or may be reluctant to do so.

Research Report | Page 23 of 23