With the financial crisis still hanging over many countries, this year's World Health Report from the World Health Organization, "Health Systems Financing: The Path to Universal Coverage" is timely and relevant to the question of how to ensure that all people have access to health care services, without suffering financial hardship. This is the conclusion of a Perspective article on the 2010 World Health Report from Sara Bennett (Johns Hopkins University, USA) and colleagues, published in PLoS Medicine to coincide with the release of the Report.

20-40% of health care expenditure is wasted, such that improved health system efficiency can make a substantial contribution to the achievement of universal health coverage. Dr Bennett and colleagues note that the key points of the report include the fact that there is no single path to achieve universal health coverage; that all countries, but particularly poorer ones, need to reduce reliance on direct, out-of-pocket payments for health care; and that

Although the authors note that the Report makes many sensible and balanced suggestions, they identify unknowns such as how countries manage the complex political challenges inherent in health financing reform, the underlying obstacles to improving efficiency in country health, and the growing burden of chronic diseases and life-style related illnesses across the world.