Universal schemes are non-contributory transfer schemes, which cover all residents, and provide benefits for all, whether working or not and irrespective of income. Often the only condition attached to the receipt of the benefit is that the person must be a long-term resident or a citizen of the country. Such schemes are mostly put in place to guarantee access to health care. They are generally tax-financed, but may require a co-payment by users of health services; sometimes with exemption for the poorest (typically the latter may receive vouchers).
Categorical schemes, which cover all residents belonging to a certain category, are also often referred to as “universal” (such as “universal” old-age pensions” covering all elderly men and women above a certain age threshold). These are closely related to universal schemes and fulfill similar functions.
Universal schemes are key instruments to eliminate coverage gaps in social security systems, because they cover the entire resident population irrespective of employment status and contributory capacity. There are convincing examples of success with universal social benefit systems in Africa, Latin America and Asia.
While some schemes are strictly speaking fully universal, such as the (NHS) in the United Kingdom and similar schemes in other countries, a number of schemes contain criteria that exclude those already covered by other schemes. Such schemes, which cover the broad majority of the population, may still be considered as universal.
In Asia, for example, notable successes have been seen in the Republic of Korea, which achieved full population coverage for health care in less than 20 years, and Thailand, which achieved this in less than 15 years.
In recent years, the emergence of large-scale non-contributory programmes in middle- and low-income countries has brought the debate on different ways of achieving social security coverage to the foreground. While some people are in favour of means-tested or targeted programmes, others prefer universal or categorical schemes. However, each approach has its advantages and its limitations and each will depend on national values, past experience and institutional frameworks.♦
Based on International Labour Office (ILO) (2010), Social Security for social justice and a fair globalization (Geneva).