What is health financing for universal coverage?
Pooling is a core function of health financing policy. The purpose of pooling is to spread financial risk across the population so that no individual carries the full burden of paying for health care.
To make progress towards universal health coverage, countries should increase the share of prepaid revenues in the health system, and minimise fragmentation in risk-sharing mechanisms. Establishing separate schemes for civil servants, private sector workers, and poor people are examples of fragmented risk-sharing.
Coverage can be improved by consolidating fragmented pools regardless of sources of funds.
To make progress towards UHC, Ministries of Health should aim to move towards a predominant reliance on public funding for health, given the evidence that this is a pre-requisite to make progress towards UHC.
Efficient spending is also central. Ensuring a stable and transparent flow of funds to health purchasing agencies and service providers is also an important part of revenue raising policy.
All countries face decisions about what to include in a publicly-funded benefit package for health. Decisions concern which health services to include, as well as related rules such as a requirement to use the referral system, making co-payments, or being subject to waiting lists.
Benefit package design is a key instrument to steer the health systems towards UHC. Decisions about priority services take into account information on cost-effectiveness, impact on financial protection, and equity in access across a population. Ensuring the effective delivery of benefits also requires coordination with policies on revenue raising, pooling, purchasing, and service delivery.