Universal coverage with the health careinsurance function may be defined as physical and financialaccess to necessary health care of good quality for allpersons in a society. It implies protection against the riskthat if expensive (relative to an individual's orfamily's means) health care services are needed,services of adequate quality will be physically accessible,and the costs of these services will not prevent personsfrom using them or impoverish their families. Defined inthis way, the extent of protection is an importantdeterminant of performance vis-a-vis broad health and socialwelfare policy objectives, because it entails quality ofcare (a means for improving the health status of thepopulation), equity in access to effective care (a means toreduce inequality in health status), and protection againstthe risk of impoverishment as a consequence of health carecosts. This paper was motivated by the perception that, withrespect to health care financing, there is frequentlyconfusion between policy tools and policy objectives. Thepaper emphasizes the importance of distinguishing betweenthe ends and means of health policy in general, and ofhealth insurance in particular.
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