Health financing: Making healthcare affordable and accessible for everyone
Health financing: How money flows determine who lives or dies worldwide
Maria collapsed at home with severe chest pain. Her husband rushed her to the nearest hospital in their small town outside Manila. The emergency room doctor took one look at her symptoms and knew she needed immediate cardiac catheterization—a procedure that could save her life.
Then came the question that haunts millions worldwide: “Do you have insurance? Can you pay?”
Maria’s family didn’t have health insurance. The procedure cost three months of her husband’s salary. While they desperately called relatives trying to borrow money, Maria’s condition worsened. By the time they scraped together enough cash, it was too late. She died not because treatment didn’t exist, but because they couldn’t afford it.
This is the brutal reality WHO’s work on health financing addresses. Health financing is a core function of health systems that can enable progress towards universal health coverage by improving effective service coverage and financial protection. Today, millions of people do not access services due to the cost. Many others receive poor quality of services even when they pay out-of-pocket.
WHO’s fact sheet on universal health coverage (UHC) explains these critical connections. For more on healthcare accessibility, see our articles on health insurance systems and healthcare affordability at ObserverVoice.com.
The Three Pillars of Health Financing
WHO’s approach to health financing focuses on three core functions that determine whether people like Maria get the care they need:
Revenue raising involves sources of funds, including government budgets, compulsory or voluntary prepaid insurance schemes, direct out-of-pocket payments by users, and external aid. Out-of-pocket payments—like what Maria’s family tried to gather—are the most regressive form of health financing because they hit hardest when people are most vulnerable.
Pooling of funds means accumulating prepaid funds on behalf of some or all of the population. Think of it as everyone contributing to a shared pot that anyone can draw from when sick. This spreads financial risk across healthy and sick people, rich and poor. Countries with effective pooling mechanisms ensure that individuals don’t face financial catastrophe when they need healthcare.
Purchasing of services involves the payment or allocation of resources to health service providers. Carefully designed payment arrangements can incentivize care coordination and improved quality of care. Sufficient and timely disbursement of funds to providers helps ensure adequate staffing and medicines to treat patients.
WHO’s Global health expenditure database tracks these financing flows across 190+ countries. WHO also maintains a repository of health budgets showing how countries allocate resources.
In addition, all countries have policies on which services the population is entitled to, even if not explicitly stated by government. Services not covered are usually paid for by patients through co-payments—another barrier for families like Maria’s. For more on healthcare spending, see our article on health accounts at ObserverVoice.com.
Guiding Principles for Reform
Health financing reforms cannot simply be imported from one country to another given each country’s unique context and starting point. However, WHO identifies guiding principles that support progress toward UHC:
Moving towards predominant reliance on public funding sources reduces dependence on catastrophic out-of-pocket payments. Reducing fragmentation in how funds are pooled—or mitigating the consequences—prevents situations where some population groups have generous coverage while others have none. Moving towards more strategic purchasing of health services means linking provider payments to data on their performance and to the health needs of populations they serve. Aligning coverage policies (benefits and copayments) explicitly with policy objectives ensures financing systems actually achieve intended goals.
November 2025 WHO issued guidance to address drastic global health financing cuts. October 2025 WHO launched Health Works Leaders Coalition to promote health system investments and spur economic growth. WHO’s Health Financing and Economics team coordinates technical work globally.
Learning from Country Experience
Country experience should be looked at through the lens of health financing functions rather than labels. Labels such as “social health insurance,” “community insurance,” or “tax-funded systems” have little meaning by themselves and hide the complex choices available to countries as they raise, pool, and use funds.
WHO’s fact sheet on community-based health insurance explains one approach. WHO’s fact sheet on free health care policies examines another. WHO’s fact sheet on primary health care shows how effective PHC requires adequate financing.
WHO featured Tajikistan paving the way for UHC with strong primary health care in July 2024. WHO showcased strengthening PHC with Community Health Strategy in Mozambique in August 2024. December 2025 WHO published Integrating community health workers into health systems: a step-by-step policy implementation guide.
Experience demonstrates that real progress is possible in countries at all income levels. Each country’s pathway will differ depending on local context, however the guiding principles are essential for equitable and effective progress.
The Role of Health Taxes
July 2025 WHO launched bold push to raise health taxes and save millions of lives. Health taxes on tobacco, alcohol, and sugar-sweetened beverages can simultaneously raise revenue for health systems while reducing consumption of harmful products.
January 2026 WHO published Global report on the use of alcohol taxes, 2025 and Global report on the use of sugar-sweetened beverage taxes, 2025. WHO’s infographic shows self-care interventions can help reduce health costs. WHO’s health financing policy framework illustrates connections between financing and UHC goals.
For more on innovative financing, see our article on health taxes at ObserverVoice.com.
WHO’s Technical Support
WHO activities include Addressing the political economy of health financing reform, Assessing country progress in health financing for UHC, and Fostering fiscal dialogue between finance and health.
WHO offers e-Learning course on health financing policy for universal health coverage and comprehensive building capacity for health financing training programs.
World Health Assembly passed critical resolutions: WHA64.9 on Sustainable health financing structures and universal coverage (2011) and WHA58.33 on Sustainable health financing, universal coverage and social health insurance (2005).
Health system financing is an essential component of UHC but progress also requires coordinated actions across health system pillars with particular attention to strengthening human resources for health. Related topics include health accounts, health budget, common goods for health, and universal health coverage.
Maria’s death was preventable. With proper health financing systems, she would have had insurance coverage making that life-saving procedure immediately accessible. No family should face the impossible choice between financial ruin and losing a loved one. That’s what sustainable health financing aims to eliminate—everywhere, for everyone.
For more information, visit WHO’s health financing topic page or explore related content at ObserverVoice.com.
Frequently Asked Questions (FAQs)
Health financing is a core function of health systems enabling progress towards universal health coverage through improved service coverage and financial protection. WHO’s approach focuses on three functions: revenue raising (government budgets, insurance schemes, out-of-pocket payments, external aid), pooling of funds (accumulating prepaid funds for populations), and purchasing of services (payment to providers). Millions don’t access services due to cost while many receive poor quality even when paying. Related: UHC fact sheet.
WHO identifies key principles: moving towards predominant reliance on public funding sources, reducing fragmentation in fund pooling, moving towards strategic purchasing linking provider payments to performance data, and aligning coverage policies with policy objectives. Health financing reforms cannot be imported from one country to another given unique contexts. WHO supports assessing country progress in health financing for UHC and fostering fiscal dialogue between finance and health.
WHO maintains Global health expenditure database with internationally comparable data for 190+ countries from 2000 onwards. WHO provides repository of health budgets, health financing progress matrix background indicators, and Global Health Observatory: Health financing data. Related topics: health accounts, health budget.
July 2025 WHO launched bold push to raise health taxes. January 2026 WHO published Global report on alcohol taxes, 2025 and Global report on sugar-sweetened beverage taxes, 2025. Health taxes on tobacco, alcohol, and sugar-sweetened beverages simultaneously raise revenue for health systems while reducing consumption of harmful products. Related: health taxes topic.
December 2025 WHO published Integrating community health workers into health systems: a step-by-step policy implementation guide. April 2023 WHO published Addressing persistent inequalities in service coverage and deteriorating financial protection in health. WHO provides e-Learning course on health financing policy for UHC. WHO’s Health Financing and Economics team coordinates work.
- WHO Health Financing Topic Page
- Global Health Expenditure Database
- WHO Health Financing and Economics Team
- WHA Resolution 64.9: Sustainable Health Financing Structures and Universal Coverage (2011)
- e-Learning Course on Health Financing Policy for Universal Health Coverage
Disclaimer: This article is an adaptation of publicly available information from WHO’s Health financing
health topic page (WHO, Geneva. Licence: CC BYNC-SA 3.0 IGO). WHO is not responsible for the
content or accuracy of this adaptation. This content is for informational and educational purposes
only and does not constitute medical advice. ObserverVoice.com is a news and information platform
— not a healthcare provider.
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