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Healthcare costs land 5 crore Indians in poverty

TNN|
Dec 15, 2017, 08.50 AM IST
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Beawar: A View of a general ward at the Government Hospital during the doctors' ...
About one-sixth of households in India (exceeding 10% household income) and 3.9% (exceeding 25% household income) bear such spending exceeding a household's ability to pay without reimbursement by a third party.
At least half of the world's population cannot obtain essential health services and each year about 100 million people, including in India, are being pushed into poverty because they have to pay for healthcare out of their own pockets.

'Tracking Universal Health Coverage: 2017 Global Monitoring Report', a new report by the World Bank and the World Health Organization released on Wednesday has revealed that currently 800 million people spend at least 10% of their household budgets on health expenses for themselves, a sick child or other family member.

For almost 100 million, these expenses are high enough to push them into extreme poverty, forcing them to survive on $1.90 or less a day. The report looks at "catastrophic" spending on health on the basis of out-of-pocket expenditures exceeding 10% and 25% of household total income or consumption.

About one-sixth of households in India (exceeding 10% household income) and 3.9% (exceeding 25% household income) bear such spending exceeding a household's ability to pay without reimbursement by a third party. Among the Brics countries, South Africa, which spends 8.7% of GDP on health, and Russia, which has a predominantly state-funded healthcare system, had just 0.1% and 0.6% respectively, of households spending over 25% of their income on healthcare.

This figure was 0.8% in the US. China had the highest proportion (4.8%) and in Brazil it was 3.5% of households. According to the report, 808 million worldwide incur catastrophic health spending at the 10% level. Latin America and Asia have the highest rates of people with out-ofpocket expenditures exceeding 10% or 25% of total household consumption or income.

The report states that 4.2% and 4.6% households in India, based on two different poverty lines, are impoverished by spending on health. Given that there are about 24 crore households in India, that would mean around a crore households or a population of nearly 5crore being impoverished.

In these cases, a household is forced by an adverse health event to divert spending away from things like food, shelter and clothing, to an extent that its spending on these items is reduced below the level indicated by the poverty line. The levels of health service coverage vary widely between countries.

The Universal Health Coverage (UHC) service index is highest in East Asia (77 on the index) and Northern America and Europe (also 77). Sub Saharan Africa has the lowest index value (42), followed by Southern Asia (53). The index is correlated with under-five mortality rates, life expectancy and the Human Development Index.

UHC means that all people receive the health services they need, including public health services designed to promote better health, ensuring that the use of these services does not expose the user to financial hardship. Incidence of catastrophic payment has been increasing between 2000 and 2010.

(This article was originally published in The Times of India)

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