 The WHO advocates universal coverage in low- and middle-income countries as well as in richer countries (WHO 2010). A key issue in these efforts is the comprehensiveness of the benefit package, which in some reforms is a “thin” benefit package that may not cover many needed services and that requires significant out-of-pocket payments even for covered services. An ongoing policy debate will have to address efforts to “thicken” the benefit package along the three dimensions that define it: the number of people covered, the types of services covered, and the amount of co-pays or deductibles for covered services. Disagreements with the ethical guidance WHO (Ottersen, Norheim, et al. 2014) has provided about how to “thicken” the benefit package will no doubt be part of that policy debate. Reasonable people will disagree how to trade improvements on each dimension against the others, and a process will be needed to resolve these disagreements. A related issue is whether the health system can sustainably deliver the benefit package the insurance scheme is committed to deliver.