Worldwide, about 150 million people a year face catastrophic healthcare costs because of direct payments such as user fees, while 100 million are driven below the poverty line. To the extent that people are covered by a risk pooling mechanism, their out-of-pocket expenditure will not cause financial hardship. Out-of-pocket expenditure for health also illuminates inequities in that richer countries—and richer populations within those countries—tend to have lower out-of-pocket expenditure.3 Additional indicators of access are needed for coverage, and experts at WHO are leading a working group on this challenging issue.
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Universal health coverage and the Post- 2015 Development Agenda
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