**Abstract**

Healthcare systems generally help improve clinical outcomes by increasing public financial investment. Reasonable policymaking is crucial for identifying the financial burden involved, and analytical tools related to the relationship between universal health coverage (UHC) and socio-economic factors are essential. This study, along with the context and reports related to health insurance systems, examines the financial mechanisms that support UHC and the economic factors that dominate the clinical outcomes that benefit from it. The first section examines the socio-economic factors that affect universal coverage. Examples of methods for quantitatively evaluating the relationships and their analysis results are also summarized. The subsequent section summarizes the concept of medical value and the methodology for its evaluation, which are indispensable for examining the appropriate development of medical insurance systems. Research cases related to the significance of lifesaving and drug discovery are introduced, considering the possibility of allocating public resources. In the final section, the concept of price formation, which also considers medical value, is organized from the perspective of economics and medicine, with the optimization of medical treatment behavior in mind. For example, a report that analyzes the factors of price levels, focusing on Japanese private practices, is introduced.

**Keywords:** medical fee, value of medicine, health insurance, cost accounting, costeffectiveness, service coverage index, gross domestic product, health expenditure, poverty, population, utility theory, nephrotic syndrome, childbirth
