Health financing is a key component of any health system, but its role is more complex than simply raising and spending money on health. It is a crucial determinant of the overall performance of the health system, defining, among other things, how much money is available to be spent on health and who pays for it, who gets to benefit fromthose financial resources, what services that money can purchase and who ultimately receives resources from the health system as income. Without careful attention to the way health financing systems are designed, incentives for providers or patients can bemisaligned with policy goals, leading to poor health outcomes, financial hardship for users of health care, wasted resources, failure to address inequalities and disruption of countries’ progress towards universal health coverage (UHC) (Box 0.2.1).

Beer has been taxed since 3000 BCE. It has provided a reliable source of revenue for governments since the Middle Ages because beer was easily made, relatively cheap, and therefore consumed in large quantities. Also, the collection of beer taxes developed, which helped secure it as a revenue source. The revenue raised from beer taxes was used to fund wars (such as the Dutch Revolt), strengthen governments, and protect local industry (the UK in the seventeenth century). More recently, health and behavioural concerns dominated to the point that governments were prepared to forgo the revenue in favour of prohibitions to improve the health of their citizens (US, Finland, and Norway, 1920s and early 1930s). Sadly, beer taxes did not achieve the goal of reducing consumption or the adverse behaviours previously blamed on beer. Governments later changed the basis of taxation to link it to alcohol content. This has led to an increasing trend in the development of craft beers and low-alcohol or non-alcoholic beers. Beer taxes are certainly going to continue, but they are more nuanced now, with the aim of balancing health and welfare, revenue-raising, and the free market