1. The Third Annual Global Health Economics Consortium Colloquium Valuing Health Neelam Sekhri Feachem, UCSF 1

2. Universal Health Coverage: What is It? All people can access the health services they need without incurring financial hardship. Goals: 1.Financial Protection 1.Access to Quality Services Neelam Sekhri Feachem UCSF 2

3. Current Performance Universal Health Coverage Health Status Financial Protection Emphasize primary healthcare and public health? Emphasize hospitalization insurance/catas trophic spending? Balancing Health Outcomes and Financial Protection Universal Health Coverage Source: Dean Jamison presentation 3

4. Three Dimensions of UHC Access: Expand coverage to wider population Scope and Quality: Expand quantity of health services covered and improve quality Financial protection: Expand coverage and reduce out- of -pocket payments. Adapted from who.int,and Ben Bellows, Measuring to Manage Progress towards UHC, Social Franchising Metrics Working Group Population Council

5. Hospital Care Population Served Informal Sector Costs Covered 0% 100% Formal Sector Services Covered Path #1: Historical: Europe Rich Poor Primary Care Other Services Source: Based on Jamison et al. Global Health 2035; The Lancet, Dec. 3, 2013 Neelam Sekhri Feachem UCSF 5

6. Essential Package of Cost Effective/Convergence Interventions Population Served Poor Costs Covered 0% 100% Path #2: Progressive Universalism Source: Based on Jamison et al. Global Health 2035; The Lancet, Dec. 3, 2013 More Costly/ Less Cost Effective Less Costly/ More Cost Effective Rich 6

7. Fuller Package of Benefits and 100% Coverage of Costs Path #3: Progressive Universalism Source: Based on Jamison et al. Global Health 2035; The Lancet, Dec. 3, 2013 Fuller Package of Benefits With Cost-Sharing Fuller Package of Benefits With Cost-Sharing Population Served Poor Costs Covered 0% 100% More Costly/ Less Cost Effective Less Costly/ More Cost Effective Rich 7

8. Fuller Package of Service s Typical Starting Point for UHC in Low Income Countries Basic Hospital Basic Primary care Population Served Poor Costs Covered 0% 100% More Costly/ Less Cost Effective Less Costly/ More Cost Effective Rich c Civil Servants/Formal Sector Neelam Sekhri Feachem UCSF 8

9. Source: www.healthfinancingafrica.org.www.healthfinancingafrica.org Neelam Sekhri Feachem UCSF 9