Ensuring Universal Health Coverage (UHC) is one of the defining policy challenges of the 21st century. In election periods, few issues resonate more powerfully with voters. Everywhere, people want the same simple assurance: access to good-quality health care for themselves and their family, and protection from the financial shock of illness. Health is personal, universal, and deeply political. When political leaders understand this-and act on it-they do not just improve lives; they also significantly increase their chances of electoral success. The evidence that health tops voters' priorities is unequivocal. The UN75 global survey conducted in 2020 to mark the United Nations' 75th anniversary found that access to quality health care was the single most important issue for people worldwide. The most effective response to this demand has been the creation of universal health systems underpinned by socialised financing. These systems pool resources so that the healthy and wealthy subsidise care for the sick and the poor. Today, all high-income countries-except the United States-have adopted some version of this model. Whether funded through general taxation, social insurance, or a mix of both, the principle is clear: no one should be denied care or pushed into poverty because they fall ill. Countries with strong UHC systems enjoy longer life expectancy, lower maternal and child mortality, and better management of chronic disease. A healthier population is also more productive and remains economically active for longer. UHC therefore supports sustainable economic growth as well as social welfare. Universal health systems also reduce inequality. Heavy reliance on out-of-pocket payments disproportionately harms the poorest, who often delay care, sell assets, or fall into debt to pay medical bills. Publicly financed systems redistribute resources across society, narrowing health and income gaps. When citizens know they are all contributing to and benefiting from the same system, trust in public institutions grows and willingness to pay taxes increases. Too often overlooked is the contribution of UHC to peace and political stability. Access to basic services is a cornerstone of the social contract between citizens and the state. When governments deliver on health, they demonstrate responsiveness and legitimacy. When they fail, grievances deepen-particularly in fragile or post-conflict settings. Perhaps most importantly for politicians, universal health reforms are extremely popular. Leaders who deliver health security are frequently rewarded at the ballot box and remembered as nation builders. History offers powerful examples. In the United Kingdom, the Labour Party won a landslide victory in 1945 after promising universal health care following the devastation of the Second World War. The National Health Service, launched in 1948, transformed access to care and remains the country's most popular public institution. In Japan, post-war expansion to universal health insurance helped rebuild the nation and underpin decades of economic growth and social cohesion. In Thailand, following the Asian financial crisis, Prime Minister Thaksin Shinawatra's universal coverage scheme became one of the most popular policies in modern Thai history and a key factor in his party's repeated electoral success. Nepal's own experience fits this pattern. Following the pro-republic people's movement, political leaders enshrined health as a fundamental right in the 2007 Interim Constitution. The government introduced free basic health care, essential medicines, and reproductive health services, making Nepal an early exemplar of UHC reform despite being a low-income country. These commitments featured prominently in the 2009 elections and were rewarded by voters. This precedent matters: Nepali citizens respond positively when leaders place health security at the centre of their political agenda. The 2024 Chatham House Commission on Universal Health Coverage highlights that many transitions to UHC follow periods of national crisis-economic collapse, conflict or political instability. Such moments create space for bold reform. As Nepal approaches elections this spring, universal health reform once again has the potential to be decisive. A clear path forward would be to guarantee free basic services for all while strengthening social health insurance for secondary and tertiary care, with contributions proportionate to income. Extending free hospital services nationwide-while ensuring quality-would be a bold and highly popular step. To make this sustainable and address the current crisis in insurance payments, Nepal must increase domestic public financing for health. This can be achieved by raising government revenues and increasing the share of the national budget allocated to health from the current 4.9 per cent. Raising the health budget share to 10 per cent, typical for countries at Nepal's income level, would more than double available resources. Dedicated health taxes on alcohol, tobacco, and other harmful products could further fund these commitments. Such reforms are neither unrealistic nor unprecedented. Countries across Asia-including Thailand, Sri Lanka, Indonesia, and China-have increased public health spending by 1-2 per cent of GDP to achieve or deepen universal coverage, with economic, social, and political returns consistently outweighing the costs. A new government in Nepal would not be acting alone. It could draw on global expertise through WHO-supported initiatives, academic institutions such as the London School of Economics, and peer learning from countries that have successfully implemented UHC reforms. The political message is clear. Voters want universal health protection, and they reward leaders who deliver it. Smart political leaders should seize this opportunity-to improve the lives of millions through a winning election agenda. Yates is Visiting Professor in Practice, The London School of Economics, and Dr Maskey is the Executive Chief of Nepal Public Health Foundation