Last week at the UN general assembly, the Lancet medical journal, with the Rockefeller Foundation and Results for Development, officially launched its series on universal health coverage – an idea whose time appears to have come, or perhaps returned. While the political battles are still raging in the US over access to healthcare and will continue to do so at least until Barack Obama or Mitt Romney is elected, most countries are moving towards a system that allows those who need medical treatment, but cannot afford it, to get it.

There were some raised eyebrows, however, over the name of the man who led the Lancet series. It was David de Ferranti, now president of the Results for Development Institute but, in the 1980s, a staff member of the World Bank and one of the chief proponents of the introduction of user fees.

This is what he wrote in 1985 in the abstract of his bank staff working paper, entitled Paying for Health Services in Developing Countries, which reviewed "the shortcomings of existing policies, which finance healthcare to a significant extent from public revenue sources" and looked at alternative options:

The conclusions argue that present policies need to be substantially reoriented in many countries. The conventional and still growing faith that healthcare should be totally paid for and administered by government needs to be vigorously challenged.

He cautions that extreme care must be taken in developing alternative strategies and adds that a different approach needs to be taken to preventive medicine – such as immunisations. He goes on:

Within this context of reform tailored to service-specific factors, there appears to be considerable scope for having users bear a larger share of healthcare costs, preferably through a combination of fees for services and fees for coverage, rather than either alone. The most clear-cut target for greater cost recovery is non-referral curative care, which together with referral services accounts for over two-thirds of health expenditure. Fees for many preventive services should remain below marginal private cost, and in some cases should be zero or even negative (ie, there should be incentive payments).

Some of the NGOs that have protested over the World Bank's attitude towards user fees in the past (the bank has now changed its stance) think the Lancet pieces suggest de Ferranti has undergone a Damascene conversion.

This is from one of them:

For a long time, getting healthcare has meant first paying a fee to the provider – a practice that effectively burdens sick and needy people, a small and vulnerable segment of the population, with most of the healthcare costs. For many poor people, that has meant choosing between going without needed services or facing financial ruin. Paying out of pocket is still dominant worldwide. In India, for example, patient fees account for more than 60% of health expenditure.

Countries moving towards universal health coverage, including India, are seeking to change this situation. By spreading the costs across the whole population, everyone would pay less in times of ill-health and those in need of treatment for serious illnesses would be spared from crushingly high costs. Illness would no longer regularly bring financial catastrophe.

I asked de Ferranti about the series and his support for universal health coverage today in the light of his rejection of it in the 1980s. He sees no inconsistency. He says the world has changed in 30 years. The situation then is not the one that pertains now:

If you go back to that time, the actual point that I was making was different than just saying user fees are good. I recognise that other voices in the bank and other voices talking about the bank put it that way. But the point I was making was if there is no money to get healthcare to remote areas, to poor areas or to rural areas, then the cry for free healthcare for all means no healthcare for many. And so it wasn't a sense that user fees are good in their own right but with so few resources available, one needs to look to – that was the argument being made then – those who can pay, so that those who cannot pay would be more able to get services. That's the argument that was being made.

Since then – I guess it is now 30 years – economic growth rates, higher incomes, all the forces that have led to this florescence of interest and action by countries towards universal healthcare [have] shown that more resources were available and more that could be applied to health – so that older argument no longer applies. The world has completely changed. Thirty years. Three decades. That's a long time. Things change and arguments should change. And in the presence of more resources and the ability not just financially but administratively of countries to manage these programmes, which was again not there 30 years ago, it just now makes eminent sense and I have been outspoken in this – to move towards universal health coverage systems.

Rick Rowden, author of The Deadly Ideas of Neoliberalism and a harsh critic of the user fees policy of the past, says de Ferranti and others who took a similar line were simply part of their era – "riding the political wave of the time – Reagan, Thatcher and the free market".

"I'm sure he is completely sincere," said Rowden. "I'm sure he has always meant well." He does not blame de Ferranti but, he says, the prevailing economic ideas had "tremendous impact on people's lives over many years". He speaks of the "reckless" introduction of user fees, which should have been tested out on small groups of people first, and says that later on it should have been clear that they were undermining people's human right to health.

"I'm more interested in acknowledging the victims of this 30-year economic mistake," he said. They could have a case for compensation, he says. At the international conference on primary healthcare at Alma Ata in 1978, there was a consensus on the need for universal healthcare, but the movement was derailed by the neoliberal dominance of the 1980s. "From Alma Ata to 2012 is 34 years. That is outrageous. It is amazing to think how many people must have suffered."