Some of the pre-election conversations with voters in villages of Syangja were about health care, and this is likely the case across the country, especially in remote areas. Some villagers spoke about the shortage of doctors, lack of essential medicines at local health facilities, and the difficulty of accessing specialised treatment. Others described paying large medical expenses out of their own pockets, with some families even falling into debt. A few said they had to travel to Pokhara even for relatively simple treatment. These were not just election conversations; they reflect everyday concerns that highlight a broader national challenge and point to what needs urgent attention. Political transitions can create important windows for policy change. As a new government prepares to take office, it has an opportunity to ground its health ambitions in something both practical and transformative: getting the basics right across the country's health system. For years, discussions about universal health coverage (UHC) in the country focussed on expansion, i.e., more programmes, more insurance coverage, and more benefits. Yet many citizens crave something simpler. They want a nearby health facility that offers reliable services, essential medicines that are actually available, and health workers who can provide the basic care that's needed. The most effective path towards UHC may therefore begin not with new promises, but with a clear national commitment to guaranteeing a dependable package of basic health care services (BHCS) that the country can realistically finance today. Once that foundation is secure, the country can gradually expand coverage through Social Health Insurance (SHI) as system capacity and fiscal space grow. Nepal has made notable progress in expanding health services over the past two decades, with new facilities, improved immunisation coverage, and expanded maternal health services. Yet the latest Nepal Health Facility Survey (NHFS) shows the system remains uneven. Only about three-quarters of health facilities offer the full package of BHCS expected at the primary care level, including sick childcare, growth monitoring, immunisation, family planning, antenatal care, and treatment for sexually transmitted infections. Availability varies across provinces, ranging from roughly two-thirds of facilities in some areas to around four-fifths in others. As a result, access to care still depends heavily on geography. The situation with medicines is even more troubling. Of the 18 essential medicines that should be available in public facilities, as per the NHFS, only around 1 per cent of facilities had all of them in stock. These findings suggest UHC is not only about financial protection or SHI programmes. It is about ensuring that essential services are available when people seek care. For Nepal, the first step is to clearly define and guarantee a core package of BHCS that every citizen can expect. Prioritisation is not rationing; it is how health systems protect people by guaranteeing the most impactful services first and delivering them well, everywhere. This is consistent with WHO's UHC guidance, which emphasises a primary health care-led path that ensures essential services for all, and then progressively expand depth and breadth as capacity and resources grow. This package should focus on the country's most pressing health needs, guided by a structured approach that prioritises the most cost‑effective interventions the system can reliably deliver. Once a dependable package of BHCS is in place, Nepal can gradually expand coverage through SHI. The basic package forms the health system's foundation, while insurance provides additional financial protection and access to more specialised care. Achieving this vision requires better financing and management of health care. The country's health financing structure has become fragmented, with multiple programmes and payment channels operating at once, creating confusion for citizens and delays and inconsistent incentives for providers. A more coherent approach would coordinate funding for BHCS and ensure facilities receive predictable payments. SHI could then finance services beyond the basic package, such as hospital care or advanced diagnostics, through aligned contracting and claims systems. Provider payment systems also matter. Population-based payments for primary care and case-based payments for hospital services could align incentives and encourage providers to focus on quality and outcomes. Once a clearly defined BHCS package is in place, health sector reforms become clearer and more achievable. This includes aligning the essential medicines list with the priority package and ensuring consistent availability across basic facilities. With clear priorities, medicine shortages become easier to address. Nepal already has many of the resources needed to make these changes. Government institutions, universities, professional networks, and development partners provide expertise in health policy, systems, and health economics. Where needed, collaboration with academic networks abroad could support innovation in health financing, procurement, and digitalisation. Ultimately, UHC will be judged not by policy documents but by everyday experiences: a health facility with medicines available, a health worker providing timely care, and a family not forced to choose between treatment and financial hardship. Nepal can make meaningful progress by focussing on a small, doable package of high‑impact essential services delivered well. The country does not need to solve every challenge at once. What the country needs most now is focus. By guaranteeing a dependable package of BHCS, strengthening medicine supply, and gradually expanding coverage through SHI, Nepal can deliver real improvements today while building a stronger system for tomorrow. UHC begins with a simple promise: when people seek care, the basics will be there. Dr. Aryal is a health policy and systems researcher specializing in health financing. He works closely with Nepal's Ministry of Health and Population and is affiliated with BCEPS of Norway's University of Bergen and systems researcher; while Chhetri is a development practitioner