The World Health Report: Health Systems Financing: The Path to Universal Coverage

The report emphasizes the need for practical guidance on financing healthcare, particularly for the poor, and highlights the importance of moving towards universal coverage. The report notes that the current economic downturn and rising healthcare costs have increased the pressure to make wise policy choices. The report identifies the continued reliance on direct payments, including user fees, as the greatest obstacle to progress towards universal coverage. It argues that raising funds through required prepayment is the most efficient and equitable base for increasing population coverage. This approach allows the rich to subsidize the poor and the healthy to subsidize the sick. The report emphasizes that no one in need of healthcare should risk financial ruin as a result. The report highlights the need for stable and sufficient funds for health, but notes that national wealth is not a prerequisite for moving closer to universal coverage. Countries with similar levels of health expenditure achieve strikingly different health outcomes from their investments, and policy decisions play a significant role in explaining these differences. The report also emphasizes the importance of improving efficiency in healthcare systems. It estimates that from 20% to 40% of all health spending is currently wasted through inefficiency, and identifies 10 specific areas where better policies and practices could increase the impact of expenditures. Investing resources more wisely can help countries move closer to universal coverage without increasing spending. The report proposes a menu of options for raising sufficient resources and removing financial barriers to access, especially for the poor. It highlights the importance of diversifying domestic sources of revenue, exploring sources of domestic financing for health, and external financial assistance. The report also emphasizes the need to focus on the poor and other vulnerable populations, and to address other barriers to access, such as exemptions from charges. The report concludes by emphasizing the need for countries to look for opportunities to improve efficiency before cutting spending on healthcare. It notes that investing resources more wisely can help countries move closer to universal coverage without increasing spending. The report provides a framework for countries to follow in their efforts to achieve universal coverage and improve the efficiency of their healthcare systems. The report highlights the importance of strategic purchasing, paying for performance, and eliminating waste and corruption. It also emphasizes the need to critically assess which services are needed and to incentivize health financing and efficiency. The report concludes by emphasizing the need for countries to learn from experience, support change, and take practical steps to achieve universal coverage. The report was produced under the overall direction of Carissa Etienne, Assistant Director-General, Health Systems and Services, and Anarfi Asamoa-Baah, Deputy Director-General. The principal writers of the report were David B Evans, Riku Elovainio, and Gary Humphreys, with inputs from Daniel Chisholm, Joseph Kutzin, Sarah Russell, Priyanka Saksena, and Ke Xu. The report was informed by many individuals from various institutions who provided background papers and analysis. The report was commissioned in response to a need for practical guidance on financing healthcare, particularly for the poor. The report emphasizes the importance of moving towards universal coverage, a goal currently at the center of debates about health service provision. The report notes that growing public demand for access to high-quality, affordable care further increases the political pressure to make wise policy choices.