Key messages
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Universal health coverage has been defined in terms of rights to health care, financial protection, and utilisation of health-care services
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Universal health coverage can be achieved through many different health financing systems, although the pooled share of health expenditures predominates in all successful cases
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The political processes leading towards universal health coverage differ between countries, but they are all ubiquitous, persistent, and contingent
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Political action to universalise health coverage is the major force behind the rising share of pooled financing of health expenditures
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Growth in health spending is driven primarily by rising national income and the expanding range of medical interventions, with population ageing playing a small part
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Countries that want to achieve universal health coverage need to adopt public policies that reduce reliance on out-of-pocket spending and improve the institutions that manage pooled funding to address the equity, efficiency, and sustainability of health expenditures