Protecting Households From Catastrophic Health Spending

• Published in: Health Affairs Vol. 26; no. 4; pp. 972 - 983
• Main Authors: Xu, Ke, Evans, David B, Carrin, Guido, Aguilar-Rivera, Ana Mylena, Musgrove, Philip, Evans, Timothy
• Format: Journal Article
• Language: English
• Published: United States Health Affairs 01.07.2007; The People to People Health Foundation, Inc., Project HOPE
• Subjects: Catastrophic Illness - economics; Cost of Illness; Costs; Cross-Cultural Comparison; Delivery of Health Care - economics; Developed Countries - economics; Developing Countries - economics; Expenditures; Family Characteristics; Family income; Financing, Government - statistics & numerical data; Financing, Personal - statistics & numerical data; Food; Health care expenditures; Health care policy; Health Expenditures - standards; Health Expenditures - statistics & numerical data; Health insurance; Health services; Health Services Accessibility - economics; Households; Humans; Income - statistics & numerical data; International; National Health Programs - economics; Population; Poverty - statistics & numerical data; Prepayments; Regression Analysis; Studies; Taxation; Variables
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.26.4.972

Many countries rely heavily on patients' out-of-pocket payments to providers to finance their health care systems. This prevents some people from seeking care and results in financial catastrophe and impoverishment for others who do obtain care. Surveys in eighty-nine countries covering 89 percent of the world's population suggest that 150 million people globally suffer financial catastrophe annually because they pay for health services. Prepayment mechanisms protect people from financial catastrophe, but there is no strong evidence that social health insurance systems offer better or worse protection than tax-based systems do.