Many countries have embarked on policies to remove or reduce user fees (the so-called free healthcare policy). It is not enough to be able to finance it for a year or two. It is essential to consider the medium- and long-term sustainability of the financing of this policy. Here, we propose a methodological framework for a rapid first assessment that is easy to apply in various contexts.

The financing strategy must be based on realistic assumptions and scenarios.

It is cautious to anticipate a need to adjust the policy in order to be able to provide a relevant response to a possible funding gap and avoid making important decisions in a hurry.

A commitment at the highest level of the State, above the Ministry of Health, will be necessary if funding requires an increase in public health expenditure and/or delicate trade-offs at sectoral or macroeconomic levels.