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Universal health coverage is priority for health systems worldwide, as it is seen as a
critical means to promote human welfare and sustained economic and social development
(Box 1.3). Given Hong Kong’s context as discussed, providing accessible, affordable and
well-integrated primary care that is person-centred in achieving the goals of UHC is a
continuous challenge and renders Hong Kong’s health system not fit-for-purpose.

Box 1.3

What is “universal health coverage” (UHC)?

UHC is defined by the World Health Organization (WHO) as “all people
[having] access to the health services they need, when and where they need
them, without financial hardship. It includes the full range of essential
health services, from health promotion to prevention, treatment,
rehabilitation, and palliative care.” (WHO, n.d.) UHC is based on the notion of
equity in financing. People contribute on the basis of their ability-to-pay, not
according to whether they fall ill.

In 2005, the World Health Assembly unanimously adopted a resolution urging
countries to adopt necessary health financing reforms to achieve UHC,
requiring countries to reduce its reliance on OOPs to finance their health
systems.

Figure 1.2 demonstrates a “coverage” box that illustrates the three
dimensions of health financing through which UHC can be achieved. When
the coverage box of a country is expanded along three axes, it is further
along meeting UHC. In practice, a country’s coverage mechanism must
cover more people (population axis), offer more comprehensive
services (services axis), and pay a greater part of the cost
(financial protection axis).

Figure 1.2
Three dimensions of the coverage mechanism towards UHC

Towards universal coverage

Financial protection:
what do people
have to pay
out-of-pocket

Reduce cost sharing and fees Include
other
services

Extend to Coverage
non-covered mechanisms Services:
which services
are covered?
Population: who is covered?

Sources: WHO, 2005b, 2010c, 2017a

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