ABSTRACT
Sarawak is a model of how a publicly financed health care system can achieve near-universal coverage for basic health care and preventive services – with hugely positive outcomes – at relatively low cost, albeit with some inevitable inefficiencies. Many of the inefficiencies in the system derive from the special characteristics of Sarawak – a relatively prosperous state with a significant proportion of the population having irregular or low monetary incomes,1 a large physical area with a small and unevenly distributed population about half of whom live in regions difficult to access through ordinary land transport, and a corresponding low population density in most parts of the state.
