Paying out-of-pocket for health care in Asia: catastrophic and poverty impact

Paying out-of-pocket for health care in Asia: catastrophic and poverty impact

Analysing the impact of out-of-pocket financing for healthcare on poverty in Asia

This Equitap paper analyses the extent of out-of-pocket (OOP) payments for healthcare in 14 countries in Asia, and the impact of these payments on household’s income and resources and vulnerability to poverty. It finds that the heavy reliance on OOP financing for healthcare has important consequences for living standards: in Bangladesh, China, India, Nepal and Vietnam, OOP payments absorb more than a quarter of household resources in at least one in ten households. OOP payments push a lot of families further into poverty: in 11 low/middle income countries, 2.7 per cent of the total population are pushed below the threshold of $1 per day due to payments for health care.

The paper concludes that the extent of the negative impacts from OOP payments depends on three factors: the degree of reliance on OOP financing; the nature and distribution of OOP payments; and the public sector user-charging policy and the effectiveness with which the poor are exempted from charges. The authors provide examples where targeted exemptions, implemented through a health card, have some success in shielding poor families from high payments for health care.

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