Advertisement

Catastrophic Spending on Health by Sample Households: Some Results

  • Moneer Alam
Chapter
Part of the India Studies in Business and Economics book series (ISBE)

Abstract

As was noted in Chap. 1, a good amount of literature at the all India or by states now already exists to suggest that health expenditure in India and some other low-income countries in Asia is considerably large (Bonu et al. 2007; Gottret and Schieber 2006; O’Donnell et al. 2008; Xu et al. 2003, etc.). A great deal of this expenditure—almost three-quarters or in some cases even more—is borne privately by households in many of these countries, in particular those with inadequate health-care systems. In a large number of cases, OOP spending on health causes serious implications for low-income households and affects their sustained living by affecting their normal expenditure pattern, particularly on a host of important nonfood items. A number of these issues have begun to receive much wider attention in India over the past few years, particularly after the seminal report by the NCMH (Ministry of Health and Family Welfare 2005). There has also been a growing concern over these years regarding major policy failures on the part of the centre and state governments in providing adequate resources—physical, financial and human—to meet health-care needs of the people, in particular the poor and the needy. This Commission has also explicitly recognised in its report the prevalence of a very high OOP spending on health in several low-income states—in particular by the households in lowest income deciles—and its role in pushing a significant fraction of households to face poverty and debt trap (see Section 2 of the Commission’s Report, 2005). More or less, a similar inference was drawn in Chap. 3 of this study indicating a large fraction of households sliding below poverty level after incurring OOP expenses on health. Many of them had to borrow from private moneylenders with high repayment liabilities leading to asset divestments.

Keywords

Consumption Expenditure Consumption Budget Head Count Health Payment Catastrophic Expenditure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Agarwal, B. (1990). Social security and the family: Coping with seasonality and calamity in rural India. Journal of Peasant Studies, 17(3), 314–412.Google Scholar
  2. Asian Development Bank. (2007). Key indicators 2007: Inequality in Asia. Manila: Asian Development Bank.Google Scholar
  3. Bonu, S., Indu, B., & Peters, D. H. (2007, October). Incidence, intensity and correlates of catastrophic OOP health payment in India (ERD Working Paper Series No. 102). Manila: Asian Development Bank.Google Scholar
  4. Garg, C., & Karan, A. K. (2009). Reducing out-of-pocket expenditures to reduce poverty: A disaggregated analysis at rural-urban and state level in India. Health Policy and Planning, 24(2), 116–128.Google Scholar
  5. Gottret, P., & Schieber, G. (2006). Health financing revisited – A practitioner’s guide. Washington, DC: The World Bank.CrossRefGoogle Scholar
  6. Joglekar, R. (2008, September). Can insurance reduce catastrophic OOP health expenditure. Mumbai: Indira Gandhi Institute of Development Research, mimeo. Available at: http://www.igidr.ac.in/pdf/publication/WP-2008-016.pdf
  7. Kawabata, K., Xu, K., & Carrin, G. (2002). Preventing impoverishment through protection against catastrophic health expenditure. Bulletin of the WHO, 80, 612.Google Scholar
  8. Maddala, G. S. (2005). Introduction to econometrics (3rd ed.). Chichester: Wiley.Google Scholar
  9. National Sample Survey Organisation. (2006a). Level and pattern of consumer expenditure, 2004–2005: 61st round, July 2004–June 2005. New Delhi: NSSO, Government of India, Ministry of Statistics and Programme Implementation.Google Scholar
  10. National Sample Survey Organisation. (2006b). Morbidity, health care and the condition of the aged: 60th round (January–June 2004) (Report No. 507). New Delhi: NSSO. Available at: http://mospi.nic.in/rept%20_%20pubn/ftest.asp?rept_id=507&type=NSSO
  11. NCMH, & MoHFW (Government of India). (2005, August). Report of the National Commission on Macroeconomics and Health, Chapter 2 on India’s health system: The financing and delivery of health care services (pp. 15–81). New Delhi: NCMH, MoHFW (Government of India).Google Scholar
  12. O’Donnell, O., van Doorslaer, E., Wagstaff, A., & Lindelow, M. (2008). Analysing health equity using household survey data: A guide to techniques and their implementation. Washington, DC: The World Bank.Google Scholar
  13. Peters, D. H., Yazbeck, A. S., Sharma, R. R., Ramana, G. N. V., Pritchett, L. H., & Wafstaff, A. (2002). Better health system for India’s poor: Findings, analysis and options. Washington, DC: The World Bank.CrossRefGoogle Scholar
  14. Ranson, M. K., Sinha, T., Chatterjee, M., Acharya, A., et al. (2006). Making health insurance work for the poor: Lessons from the Self-employed Women’s Association’s (SEWA) community-based health insurance scheme in India. Social Science & Medicine, 62, 707–720.CrossRefGoogle Scholar
  15. Roy, K., & Howard, D. H. (2007). Equity in OOP payments in hospital care: Evidence from India. Health Policy, 80(2), 297–307.CrossRefGoogle Scholar
  16. van Doorslaer, E., O’Donnell, O., Rannan-Eliya, R. P., et al. (2007, November). Catastrophic payments for health care in Asia. Health Economics, 16(11), 1159–1184.CrossRefGoogle Scholar
  17. Xu, K. (2004). Distribution of health payments and catastrophic expenditure methodology (Discussion Paper No. 2-2005 (EIP/HSF/DP.05.2)). Geneva: WHO. Available at: http://www.who.int/health_financing/documents/dp_e_05_2-distribution_of_health_payments.pdf
  18. Xu, K., Evans, D. B., Kawabate, K., et al. (2003). Household catastrophic health expenditure: A multicountry analysis. The Lancet, 362(9378), 111–117.CrossRefGoogle Scholar

Copyright information

© Springer India 2013

Authors and Affiliations

  • Moneer Alam
    • 1
  1. 1.Institute of Economic GrowthDelhi UniversityDelhiIndia

Personalised recommendations