Given the growing complexity of health care, current global demographic and epidemiologic trends, adverse economic conditions in many parts of the world, and limited national budgets, it is increasingly difficult for policy makers and regulators to ensure continued access to affordable and high-quality health care. Decision-makers must implement policies that support efficient, equitable, and sustainable health systems. To that end, this special issue aims to foster dialogue on the current state of health-care financing and some of the challenges that lie ahead for health systems. The objectives of this special issue are threefold: (1) to analyse trends in health-care financing in a range of countries with varying degrees of economic development and political organization; (2) to review the viability of different financing models based on international experiences; and (3) to examine how efficiency in health care systems can be achieved without sacrificing quality. The issue consists of three sections and includes contributions from academic experts, health-care practitioners, and members of the broader stakeholder community.