Redesigning coverage policy to make health care affordable for everyone

At this year’s European Health Forum Gastein (EHFG), the WHO Barcelona Office for Health Systems Strengthening led a session on how countries can ensure that out-of-pocket payments for health services do not expose people to financial hardship. Efforts to reduce financial hardship are at the core of universal health coverage.

The session presented new evidence from WHO showing how copayments for health care lead to financial hardship in a wide range of countries in the WHO European Region. Some aspects of copayment policy design are more harmful than others, however.

Several European Region countries are transforming complex, unfair and bureaucratic copayments to reduce financial hardship and unmet need, particularly for prescribed medicines. Effective strategies include copayment exemptions for poor people, regular health-care users and social beneficiaries; implementing annual caps on all copayments – ideally caps linked to household income; replacing percentage copayments with low fixed copayments; keeping rules simple; and minimizing bureaucracy.

With experts from Austria, Estonia, the European Commission and the European Patients’ Forum, the session explored how obstacles to fairer copayment policy and financial protection can be overcome in the future.