“We wouldn’t have been in such trouble if we didn’t have to pay for my father’s medical expenses,” rues Sonam Kumari, daughter of Babita Devi and Arjun Das. After receiving treatment for a brain tumour at AIIMS, Arjun has partial paralysis of the body – they had to stop his medications because they couldn’t scrape together the money anymore.
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Out of pocket medical expenses make up about 62% of all healthcare costs in India.
What are out of pocket expenses (OOPEs)?
In simple terms, out of pocket expenditure refers to one’s expenses for medical care that one’s insurance does not cover. WHO defines it as “direct payments made by individuals to health care providers at the time of service use.” They exclude any reimbursement by a third party such as the government, a health insurance or a private insurance company.
How it is a burden for individuals?
For people like Sheikh Ayub, taking huge loans from money lenders can become a financial burden which they will never be able to get out off.
“I don’t earn that kind of money, where will I get so much money? I’ve taken loans of about Rs. 2 lakh,” says Sheikh Ayub, whose son was diagnosed with cancer in 2017 and is currently undergoing treatment at GTB Hospital.
District-level Primary Healthcare Centers (PHCs) in India are in a deplorable state, which offer poor primary healthcare to patients, leading them to seek treatment from private healthcare facilities which are very expensive. This is pushing about 63 million Indians to poverty every year, forcing them to take enormous loans, which they often struggle to pay off, losing everything in the process of paying for the treatment of a family member.
“What do I mortgage?” asks Babita Kumari, “We only have the house. If we sell the house, where will we stay?”
How do we reduce OOPEs?
Setting up Universal Health Coverage is a step in the right direction to ensure everyone everywhere in the country gets access to quality healthcare without facing severe financial strains. This can be achieved by reducing OOPEs, increasing the government spending on healthcare from 2% to 5-6% of GDP, strengthening PHCs, increasing the availability of the free medicines, etc.
It is important that India urgently increases its share of the GDP which will ensure that we also are a step closer to achieving the SDGs by 2030 and ensuring #healthforall.