Affordable Access

Financial risk protection & chronic disease care

The Indian Journal of Medical Research
Medknow Publications
Publication Date
  • Commentary
  • Economics
  • Medicine
  • Political Science


The rapid and substantial rise of chronic diseases in India – morbidity, mortality and disability – has implications for cost to the government, to the society and to families and individuals1. Further, the absence of pre-payment and risk pooling mechanisms, combined with the dominance of market-based health and medical transaction exposes substantial segment of the populations to financial vulnerabilities resulting in catastrophic payments to cover health-related costs2. Households end up mortgaging assets, exhausting savings, selling livestock and borrowing funds from private money-lenders at usurious interest rates. According to a recent National Health Accounts (NHA) estimates, India spent about 4.13 per cent of its Gross Domestic Product (GDP) on health care during 2008-2009, while the public health expenditure was only 1.10 per cent of the GDP3. Currently, nearly 70 per cent of all health spending in the country comes from the households, while roughly about 70 per cent of all health spending on health care is devoted to purchase medicines from the open market4. A recent study suggests that close to half of all households’ out-of-pocket (OOP) spending on health care is incurred on non-communicable diseases (NCDs)5. Such a magnitude and spending pattern has implications for catastrophic payments and impoverishment of households. Recent estimates suggest that globally nearly 150 million suffer from financial catastrophe and about 100 million are impoverished annually because they need to pay for health care costs6. In India, nearly 40 million are impoverished (close to half of all global impoverishment) and a substantial share of the population faces financial catastrophe7. A single episode of hospitalization for heart diseases or cancer cases in private health facilities could completely wipe out nearly 80-90 per cent of per capita income of Indians5. In this issue, Daivadanam and colleagues report the magnitude of catastrophic health expenditure associated with coronary heart diseases (CHD) and the

There are no comments yet on this publication. Be the first to share your thoughts.