Most health systems fail to offer adequate financial protection to citizens because of insufficient financial risk pooling and prepayment mechanisms. The harm caused by inadequate financial protection goes well beyond that measured by conventional indicators such as catastrophic and impoverishing health spending. A broader set of metrics is required to better inform policy development on financial protection, including new indicators that identify citizens who cannot afford to use health services and may have very low or no health spending. Options include expanding the use of household surveys that assess cost barriers to health care access and the calculation of “need-adjusted” estimates of medical care utilization and spending.

Full citation: Moreno-Serra, R., Millett, C. and Smith, P. (2011), “Towards improved measurement of financial protection in health”, PLoS Medicine, 8(9): e1001087.