Health policy, compared — how countries pay for healthcare

Universal health coverage means all people getting the quality health services they need without financial hardship.

Two parts

It has two parts: services that are available, and financial protection so using them does not push people into poverty. WHO and the World Bank’s 2025 monitoring report track both parts — a service coverage index and the share of people facing financial hardship from health spending. Read the full guide: What is universal health coverage?

In a single-payer system, one public entity pools the money — usually from taxes or mandatory contributions — and pays providers.

Financing, not delivery

The government writes the cheques, but it does not necessarily run the hospitals. That is the key distinction: single-payer is about financing, not delivery. Read the full guide: What is single payer health insurance?

Most systems mix the models

Most real systems mix these models. The table is a starting point, not a label for a whole country. Read the full guides: Health system models, explained and How health systems work around the world — or compare six countries in the Health System Comparison tool. For the head-to-head comparison, see Health system models compared, and for how one major comparison works, see Comparing health systems: Mirror, Mirror.

Countries pay through taxes, payroll contributions, premiums, or a mix — and through out-of-pocket payments where coverage is thin.

Free at the point of use is not free

“Free at the point of use” is not the same as free: somebody pays, through the tax and contribution system. No system is free, and no system covers everything. Read the full guide: How healthcare is funded. For the full financing picture — what countries spend, and what financial protection means — see How countries pay for UHC. For what the US mix costs Americans in practice, see US health-insurance costs, explained.

England — the NHS

England’s NHS is a national health service: public coverage for all, funded from general taxation, with GPs as the first point of contact.

Canada — single-payer

Canada runs single-payer national health insurance through provincial and territorial plans.

Taiwan — one national insurer

Taiwan runs a single national insurer.

Germany — sickness funds

Germany runs regulated non-profit sickness funds.

Where to read more

Each is described in plain terms in the single-payer guide. For full profiles — the model, who pays, who delivers, what is free, and the key figures — see Country profiles: fifty-six health systems: the United Kingdom, Canada, Australia, Germany, France, Japan, United States, Netherlands, Sweden, Switzerland, Spain, Brazil, India, Nigeria, New Zealand, Norway, Denmark, Italy, Mexico and Chile, China, Israel, Singapore, Türkiye, Indonesia, Vietnam, Ethiopia, Iran, Pakistan and Philippines, Austria, Belgium, Czechia, Estonia, Finland, Greece, Hungary, Iceland, Ireland, Korea, Latvia, Lithuania, Luxembourg, Poland, Portugal, Slovak Republic, Slovenia, Colombia and Costa Rica, Argentina, Bulgaria, Croatia, Peru, Romania, South Africa and Thailand.

Health financing

Health financing is how money for health is raised, pooled and spent — and whether paying for care leaves people worse off. About 2.1 billion people faced financial hardship from out-of-pocket health spending in 2022 (WHO and World Bank, UHC Global Monitoring Report 2025). Read the full guide: How healthcare is funded — the three jobs of raising, pooling and purchasing, the financial-protection figures, and what countries spend.

Global health security

Global health security is the work of preventing, detecting and responding to health threats that cross borders. Its anchors are the International Health Regulations (2005) and the WHO Pandemic Agreement, adopted on 20 May 2025. Read the full guide: What is global health security? For the policy behind it, read What is public health policy?, and for what is happening now, read Pandemics happening now.