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Medical bills make poor poorer

WHO report says 16 per cent Indians have sunk below poverty line to meet health costs, reports Aditya Ghosh.

india Updated: Feb 05, 2007, 05:09 IST
Aditya Ghosh
Aditya Ghosh

Poverty in India has a new cause — rising medical bills. According to a survey conducted by the World Health Organisation (WHO), many Indian families have been pushed below the poverty line due to heavy medical expenses, all because they could not afford basic hygiene, nutrients and sanitation. 

The study — World Health Survey — was conducted by the Indian Institute of Population Sciences (IIPS) on behalf of WHO in six states, Maharashtra, Karnataka, Himachal Pradesh, West Bengal, Tamil Nadu and Uttar Pradesh. The survey was conducted on about 10,000 families from the lower income group in the period 2002-05, and results were declared in October 2006.

The survey reveals that over 16 per cent of the study population were pushed below poverty line, while 12 per cent had to even sell their assets to meet health expenses. A whopping 43.3 per cent had to borrow from outside the family to cover the costs.

Lack of drinking water, sanitation and pollution-free fuel, still unavailable to a  majority of the poor in India, made them vulnerable to health hazards and eventually leading to higher health expenditure.

Nearly 84 per cent cannot afford vegetables and fruits due to their rising costs, making them vulnerable to diseases.

According to WHO, a household that is forced to reduce its basic expenses over a certain period of time, to cope up with its medical bills of one or more of its members, it is termed ‘Catastrophic healthcare spending’. In India, over 12 per cent of the poor fall in this category.

While the average expenditure on health of a single middle class Indian family Rs 116.7 a month, the spending rises to Rs 202 for the poor — which is half their monthly income.

Surprisingly, the biggest chunk of the expenses is attributed to medicines, which the poor should get free from government hospitals. “Many a time, the medicines are either not available or not offered to the poor with increasing privatisation in the government hospitals,” said a public health expert in Mumbai.

With no insurance, the poor have been left with no choice but to spend from their pockets.

“A serious policy intervention is required to develop insurance as an important source of health financing,” said P.N. Mari Bhat, director, IIPS, and one of the investigators of the survey.

Also adding to the poor’s woes is the bug of privatisation that has bitten into many a health schemes like free treatment for poor in hospitals, free medicines, free beds in public hospitals, free check-ups.

“The policy framework never focused on improving the overall health conditions before withdrawing welfare schemes owing to privatisation,” claims Arun Bal of Association for Consumers’ Action on Safety and Health (ACASH) of Mumbai.

“The state governments are not interested in creating healthy and hygienic living conditions in the cities and villages. Due to this, the poor fall ill and are forced to spend more,” he said.

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