More than half the world’s population does not have adequate access to some of the essential health services they need, and 100 million people are pushed into extreme poverty every year by health care spending. The global move toward universal health coverage, one of the UN’s sustainable development goals for 2030, would give everyone access to quality services without financial hardship. Reaching that endpoint demands strong leadership, good governance, and an engaged community, along with strategies for sharing financial risks, training an adequate workforce, and strengthening primary care. The payoff comes not only in better health, but in reducing poverty and promoting growth.