Medical costs push 78 million Asians into poverty

BRITAIN: International health experts have estimated that 78 million more Asians than previously thought are living in poverty because of healthcare costs.

Many people in Asian countries do not have health insurance and pay for doctor bills and medical treatments. But the out-of-pocket health expenses they incur are not included in conventional estimates of poverty.

When researchers deducted the medical costs from total household resources in 11 Asian countries, millions more people fell below the internationally accepted poverty threshold of $1 per head per day.

"If you allow for direct out-of-pocket healthcare payments, there are another 78 million counted as poor," said Dr Eddy van Doorslaer, a health economist at Erasmus University in the Netherlands who headed the research team.

"We calculated that an additional 2.7 percent of the population under study ended up with less than $1 a per day after they had paid for healthcare."

The figures, which are reported in the Lancet medical journal on Friday, are based on information from national expenditure surveys of what people spend on medical care in the various countries.

The researchers extrapolated the national, representative samples to cover the entire population. Overall the study showed the prevalence of poverty was 14 percent higher than other estimates that did not include out-of-pocket healthcare costs.

"We were surprised to see that such a large share of healthcare is paid for out-of-pocket," said Van Doorslaer.

"A lot of that is incurred by people living just above the poverty line and are pushed below it as soon as they have to incur these expenses," he added.

Indonesia, Thailand and Malaysia had the lowest burden of healthcare payments in the study. The situation was more striking in larger nations such as Bangladesh, China, India, Nepal and Vietnam.

"Those are all countries where more than 60 percent of total healthcare costs are paid out of pocket," said Van Doorslaer.

In Bangladesh and India nearly 4 percent of the population fell below the $1 a day threshold after the out-of-pockets costs were considered.

Sri Lanka, the Philippines and Kyrgyzstan were also included in the study.

"A large proportion of the Asian population is at risk of substantial financial outlays for healthcare," said Van Doorslaer, adding that methods to reduce risk, such as public or private health insurance, are needed.

LONDON, Friday, Reuters