Throughout, the United States has been an exception. In developing countries, progress was more erratic, characterized by debates about the affordability of universal health care, until it was realized that functioning health systems were essential to deliver development goals. In Europe, it emerged from a belief in solidarity, a fear of revolution, and a changing view of the role of the state. This has been an explicitly political process. This article describes how many countries, both developed and developing, have pursued the quest to achieve universal health care. Yet its benefits are still denied to many people worldwide. Over the past 50 years, health care has been making a growing contribution to population health in many countries.
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