S-1988-02-1988_OVE
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L’ASSOCIATION MIDICALE MONOIALE. INC LA ASOCIACION MEDICA MUNDIAL. INC
THE WORLD MEDICAL ASSOCIATION, INC.
28 AVENUE OES ALPES • 01210 FERN!Y·VOLTAIRE • FRANCE
P. O. BOll:: 69
Cable Address :
WOMEOAS. FERNEY·VOLTAIRE
September 1988
WORLD MEDICAL ASSOCIATION STATEMENT
on
ACCESS TO HEALTH CARE
TeleDlone:: SO 40 75 75
Telex :: 385755F WMASFVF
Telmll: SO 40 59 37
10.70
Original: English
Adopted by the 40th World Medical Assembly,
Vienna, Austria, September 1988
PREAMBLE
1~,.. “,…… ~ …. m.:”,H ,…::11 ~ar~ isa multi-dimensional concept that involves
Access to medical care is a multi-dimensional concept that involves
a balancing of factors within the practical constraints of a specific
country I s resources and capabilities. The factors include manpower,
financing, transportation, freedom of choice, public education,
quality, and allocation of technology. The balance of those elements
which maximizes the quantity and quality of care the population
actually receives, determines the nature and extent of access to
care.
” GUIDELINES
MANPOWER
National Medical Associations should Jo~n with other concerned groups
from both the private and public sectors to address issues related
to the supply and distribution of health manpower. Data should be
collected to assess supply and distribution and determine the
appropriate mix of health professionals and health workers that can
effectively meet the needs of the population. Special efforts should
be made to attract physicians and allied health care providers to
underserved geographic areas through a variety of incentives and
programs. Looking ahead to long-term needs, incentives should also
be created to attract medical school students who wish to work in
regions where there are manpower shortages.
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FINANCING
– 2 – 10.70
A pluralistic financing system should be developed that contains
elements of both public and private funding. The system should be
based on standards of uniform eligibility and benefits, and it should
include adequate payment mechanisms for this purpose. These mechanisms
should be clearly explained to the pUblic so that all concerned
understand the payment options available to them. Where appropriate,
incentives should be provided for those in the private sector to
provide care to patients who otherwise would not have access to it.
No one who needs care should be denied it because of inability to
pay. Society has an obligation to provide a reasonable subsidy for
needed care, care of the needy, and physicians have an obligation
to participate to a reasonable degree in such subsidized care.
Governments have an obligation to administer such plans fairly and
objectively.
TRANSPORTATION
Society has an obligation to provide transportation to medi~
facilities for patients who live in remote areas. Transportat~
should also be provided to rural patients who require a sophisticated
level of care that can be found only in metropolitan medical centers.
Physicians have an obligation to offer reasonable support to such
plans.
FREEDOM OF CHOICE
All health care delivery systems should provide each individual with
the greatest possible personal freedom of choice in selecting a
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provider or health care mechanisms, regardless of whether they are
based in the private or public sector. To promote informed personal
choice, adequate information concerning both private and public sector
options should be made available to the pubLi,c providers, employers
and other payors of health care.
PUBLIC EDUCATION
Educational programs that assist people in making informed cho~.s
about their personal health and about the appropriate uses of .h
self-care and professional 'care should be established. These programs
should include information about the costs and benefits associated
with alternative courses of treatment: the use of professional services
that permit early detection and treatment, or the prevention, of
illnesses~ personal responsibilities in preventing illnesses and
the effective use of the health care system.
In local communities, it is important that the public understand
health care plans designed for their benefit and how these plans
affect everyone concerned. Physicians have an obligation to actively
participate in such educational efforts.
QUALITY
Quality assurance mechanisms should be part uf every system of health
care delivery. Physicians, in particular, should accept a
responsibility for being guardians for the quality of medical care
and should not allow other elements of access consideration to
jeopardize the quality of care provided.
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ALLOCATION OF TECHNOLOGY
– 3 – 10.70
Guidelines should be developed for the allocation of scarce health
care technologies in order to meet the needs of all patients.
CONCLUSIONS
Access appears to be maximized when the following conditions exist:
Adequate medical care is available to every individual (i.e. no
physical or time constraints.)
– There is maximum freedom of choice of providers, delivery systems,
and payment systems to accommodate the diverse needs of the
population.
– Information, education and awareness by the public of every aspect
tt relating to access to care.
Adequate participation by all parties in systems design and
administration.
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