Skip to main content

High medical costs pushed 38 million Indians into poverty, led to financial catastrophe of 18% households

By Rajiv Shah
A recent paper, published in a top London-based research journal, BMP Open, has said that the out of pocket (OOP) expenditure on healthcare in general and medicines in particular, over the last two decades, has gone up from 4.49% to 6.77% in India, leading to “financial catastrophe” of 18% of the country’s households.
Calling it a “significant increase since 1993–1994”, the paper, “Quantifying the financial burden of households’ out-of-pocket payments on medicines in India”, by Sakthivel Selvaraj, Habib Hasan Farooqui and Anup Karan, says that, as against this, the proportion of OOP expenditure on food and non-food items has remained more or less stagnant.
The paper further says that OOP on medical expenditure was particularly “catastrophic” for the poorer 10% of the population, pushing 3.09% or 38 million persons, into poverty. “Among the leading cause of diseases that caused significant OOP payments are cancers, injuries, cardiovascular diseases, genitourinary conditions and mental disorders”, the report adds.
At the same time, the paper says, "The number of households facing catastrophe" on account of medical expenditure "is approximately 46 millions", of which 29 million households incurred catastrophe on account of OOP payments on medicines alone."
Of the 18% of Indian households that “appear to suffer financial catastrophe” as a result of OOP spending, the paper underlines, of this, “medicines’ OOP expenditure alone contributed an estimated 11%.”
The paper further states, “Recent evidence from the National Health Accounts for India points out that during 2013–2014, an estimated INR1331 per capita was spent on medicines, while households alone contributed INR1200 per capita, accounting for 90% of all medicines expenditure in the country.”
On the other hand, the paper says, evidence about government expenditure on medicines in India shows that, on an average, government spent about 10% of health expenditure on medicines. However, the national average masks significant under-spending on medicines by several state governments, “with many reportedly spending less than 5% of their health budgets.
Pointing out that the supply of free drugs in government health system in the outpatient care setting has “declined sharply” from about 18% to 5%, the paper says, “Drugs prescribed during hospitalisation for free also declined significantly from one-third.”
Basing on secondary data of the nationwide Consumer Expenditure Surveys for the years 1993–1994, 2004–2005 and 2011–2012, carried out by the Government of India’s National Sample Survey Organization (NSSO), and NSSO’s “Health and Morbidity Survey”, 2014, the paper says, “Over three-fourth of all healthcare payments are paid out of pocket (OOP) at the point of service delivery while medicines purchase.”
According to the paper, “Over 80% of populations are reportedly spending OOP while seeking treatment”, adding, two decades earlier, the “proportion of population reporting any OOP payments” was “about 60%”. It adds, “In respect to medicines spending, approximately every OOP spending is associated with expenditure on medicines.”
“If we were to net out food expenditure from total household consumption spending, which are considered a necessity, the share of health spending remained stagnant but as high as 11%–12% during the period under consideration”, the report notes.

Comments

Urvashi Devi said…
Why ? Now they have the generic medicines, free dialysis; 5 lacs insurance ; and they also get cover with banking schemes; that I know because we did it for all our staff; reduced price of Valves ; knee operations etc etc ; free treatment for ST Sc health card holders . So I don't understand ?
Ashwin Desai said…
You are absolutely right, God knows when will government make serious & strict policy?

TRENDING

Astonishingly sycophantic: Ex-Gujarat topcop on 2002 Godhra riots probe panel report

By Rajiv Shah  In a scathing critique of the 2002 communal riots inquiry commission report, released by the Gujarat government in December 2019 five years after it was submitted, the State’s former topcop RB Sreekumar has said that it “unequivocally” and “meticulously” takes care “to refrain from probing and taking cognizance of any deviant action of omission and commission by the State administration, particularly those operating in the criminal justice system, who facilitated extensive mass violence and enabled brigands to perpetrate anti-minority crimes.”

Two of 12 top caste-based sexual violence cases from 'model' Gujarat: NGO report

By Rajiv Shah   The National Council of Women Leaders (NCWL), a civil rights group, has compiled what it has called “landmark cases of caste-based sexual violence” between 1985 and 2020 to mark the first anniversary of the notorious Hathras gangrape case, which led to the death of a young Dalit woman in September 2020.

Riddled with Brahmanical mindset, India's health care 'serving' corporate interests

By Vidya Bhushan Rawat*  In this second part of my conversation (click here for first part), Dr Manisha Bangar speaks about the health crisis in India how the government is trying to privatise things, and where our response during the Corona period was lacking. She also gives us an understanding of people opposing nutritious meals for children in the mid-day meal.

Swami Vivekananda's views on caste and sexuality were 'painfully' regressive

By Bhaskar Sur* Swami Vivekananda now belongs more to the modern Hindu mythology than reality. It makes a daunting job to discover the real human being who knew unemployment, humiliation of losing a teaching job for 'incompetence', longed in vain for the bliss of a happy conjugal life only to suffer the consequent frustration.

Buddhist shrines were 'massively destroyed' by Brahmanical rulers: Historian DN Jha

Nalanda mahavihara By Our Representative Prominent historian DN Jha, an expert in India's ancient and medieval past, in his new book , "Against the Grain: Notes on Identity, Intolerance and History", in a sharp critique of "Hindutva ideologues", who look at the ancient period of Indian history as "a golden age marked by social harmony, devoid of any religious violence", has said, "Demolition and desecration of rival religious establishments, and the appropriation of their idols, was not uncommon in India before the advent of Islam".

Inaccurate gender-relevant data 'spoiling' government policy on Covid social impact

By Simi Mehta*  The impact of the Covid-19 pandemic has been different across vulnerable groups. They were hit by the pandemic at various stages, whether it was accessibility to medical treatment or financial support. The second wave witnessed human suffering at a level where one can never forget the traumatized faces of people due to the inaccessibility and unavailability of essential medical services such as hospitals beds and oxygen. The probability of the third wave has also been one of the major upcoming challenges.

Anti-Dalit atrocities increase 9.4% despite pandemic, Uttar Pradesh tops the list: Report

By Rahul Singh* Data on crime against Dalits and Adivasis in the Crime In India Report, 2020 draws a distinct pattern of similarity between rural and urban spaces. Published by the National Crime Records Bureau (NCRB), they capture some anomalies and interesting trends. The report also shows that a large proportion of crimes against Dalits and Adivasis involves crime against women.

Vindictive raids? Centre 'retaliates' after Delhi govt child rights body's clean chit to ex-babu

By Our Representative  Over 700 academics, advocates, activists, civil servants, writers, film makers, journalists, musicians and artists have condemned the raids by the Enforcement Directorate (ED) on the offices and private home of top IAS bureaucrat-turned-human rights and peace activist Harsh Mander, stating, the aim is nothing but to “harass and intimidate” him.

Flamboyant 'demagogues' adjust politics, personality in shadow of democracy

Modi, Erdogan, Bolsonaro By Ajit Singh The terms dictators and demagogues are used interchangeably in various contexts, but there is a difference. The former rule over a totalitarian states where governments are able to exercise complete influence over every aspect of citizens’ life, whereas the latter are a "wannabe dictators" but due to the system of checks and balances they are are not fully capable to create police states.

Power supply lines in Thar 'pushing' Great Indian Bustard to extinction: Researchers

By Rosamma Thomas*  Electricity supply lines pose a huge risk to birds and affect biodiversity, but there is little research about the numbers of birds dying of such collision in the tropical nations. In August 2021, academic journal Biological Conservation carried the results of a survey conducted in 2017-18 on 4,200 sq km of the Thar Desert in Jaisalmer district of Rajasthan. This was the first comprehensive survey of this nature in the region.