Assessing Private Sector Involvement in Health Care and Universal Health Coverage in Light of the Right to Health

The goal of universal health coverage is to “ensure that all people obtain the health services they need without suffering financial hardship when paying for them.” There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability, and quality of health care services; they may not be in a position to provide “public goods”; or they may operate under imperfect information. This paper sets out to answer the question, what legal human rights obligations do states have in terms of regulating private sector involvement in health care?


The aim of UHC—which is closely connected to the right to health—is for everyone to have access to a full range of good-quality and affordable health services. Countries around the globe have had mixed experiences with regard to private actor involvement in the health sector. The consequences of such involvement should be monitored very carefully.

Human rights law does not interfere with the state’s choice of its health care system—that is, whether it is public, private, or mixed. However, it provides an authoritative set of legal tools for assessing the consequences of private sector involvement. Based on human rights law, governments have an obligation “to protect” the right to health. This means a duty to adopt regulations and other measures to regulate all actors in the health sector. Such regulation should reflect the state’s duty to ensure that health services are available, accessible, acceptable, and of good quality. As we have suggested in this article, governments can be encouraged to conduct human rights impact assessments to assess the consequences of privatization prior to its introduction. We have also briefly asserted that states’ duty to fulfill entails, among other things, an obligation to secure the financing of their health system, such as through taxation and in collaboration with the private sector.

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