By Arab News
By Ranvir Nayar*
Unexpected hospitalization or emergency health care costs lead many families to fall into poverty across the world. The World Health Organization (WHO) says that about half the world lacks essential health services; nearly 100 million people are pushed into extreme poverty due to health care payments, and over 930 million people around the world spend over 10 percent of their household budgets on health care. In some countries, as much as 25 percent of the entire population is vulnerable to falling into this trap even through a routine visit to a hospital.
Various reports have pointed to a strong correlation between access to health care and inequality. While the rich have access to the most expensive treatments without it reflecting on their bank balances, largely thanks to well-padded insurance policies, lower income families on the threshold of poverty lack such benefits.
An illness is a double blow for these families, as they cannot afford the cost of treatment, nor the loss of income from the sick member, especially if they are the sole or main earning member of the household.
The loss is not limited to that household either, as every illness impacts the overall economy of the country. By cutting the number of productive days lost to illnesses, poorer countries can add significant economic growth. This is the principal reason, besides the humanitarian issue involved with illnesses, that the WHO calls on governments to ensure that health care is not underfunded, as is often the case in poor and developing economies.
Heeding the WHO, several have moved toward broadening their health care safety nets by targeting economically weaker demographics. While many developed nations, notably EU member states, have generous health care protections for their entire populations, some developing nations have also followed them and launched universal health coverage (UHC), ensuring the poor do not incur additional, crippling expenses.
One of the first countries in the developing world to launch UHC was Thailand, which took the plunge in 2002. Over 17 years later, Thailand appears to be the star performer in the region. The WHO commends the country, saying that despite sustained periods of political instability and a relatively weak economy, Thailand has made good progress. Within a decade, life expectancy has risen from 71.8 years to 74.2; there has been a decline in infant mortality rates, and significantly fewer households have been hit by out-of-pocket expenses for illnesses. Average household savings, meanwhile, have risen in line with that decline.
The WHO also says that higher expenditure on medicines and medical supplies boosted economic growth through increased demand in sectors like chemicals, pharmaceuticals, energy and transport. It says that the success of the program also ensured that it survived two military coups and seven prime ministers in that period.
Another early believer in UHC was the tiny Himalayan state of Nepal, which adopted it in 2008. In 2015, the move toward UHC was accelerated as health was made a fundamental right in the country’s new constitution. Nepal has made dramatic progress in several benchmarks vis-a-vis the health of its population, yet the government has not cut back its funding, which is at over 5 percent of the total government budget, in contrast with India, which spends a measly 3 percent of its budget on health care.
A number of other nations have joined in. El Salvador has abolished user fees and improved health care infrastructure as part of an ambitious plan to expand health coverage, especially in remote and poor rural areas. African nations like Liberia, Gabon, Ghana, Sierra Leone and Rwanda have also made progress toward UHC.
India, the second-most populous country in the world, has also been tinkering with UHC by slowly expanding the net for the poor. Last year, the government launched an ambitious plan offerring health coverage to nearly 500 million people. However, India has not backed that up with funding: As a share of the total government spending, the country’s health budget has actually declined over the years.
The health insurance scheme also suffers from an inherent weakness, as the government has failed to spend adequately on building health care centers and hospitals in rural and remote areas, forcing people to travel longer distances than are feasible, or resort to non-accredited, fee-charging hospitals, defeating the purpose of the scheme.
India needs to follow the examples of its neighbors, boost its health budget, and build a system that can actually offer UHC. It has committed to provide it by the year 2030 as part of the UN’s Sustainable Development Goals. The benefits of a healthy population outstrip all costs that may have deterred governments from spending in the past.
- Ranvir S. Nayar is the editor of Media India Group, a global platform based in Europe and India that encompasses publishing, communication and consultation services.