Protecting citizens against the financial consequences of illness has long been a key objective of health systems worldwide. In the United Kingdom for example, financial protection—which refers to how far people are protected from the financial consequences of illness—was the fundamental goal when the National Health Service was established in 1948, more than health improvement or equitable access to health care. The World Health Report 2000 identified financial protection against the costs of ill health as a fundamental objective of health systems, on the basis of the premise that a fair health system ensures households make health care payments according to their ability to pay rather than risk of illness. This report helped put financial protection at the forefront of health policy and academic debates, leading to numerous studies concerned with identifying the determinants of financial protection levels.

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