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Healthcare costs are driving poverty in Europe. How is Albania positioned?

2023-12-14 10:56:11Biznes SHKRUAR NGA REDAKSIA VOX

Healthcare costs are driving poverty in Europe. How is Albania positioned?

The WHO has published a new study that looks at healthcare systems in 40 European countries, focusing on their state before the pandemic. The overall findings are particularly poor, showing that millions of Europeans are experiencing financial difficulties related to health care. The phenomenon is particularly driven by the expectation that patients must make upfront, out-of-pocket payments, even if these charges will be reimbursed at a later stage.

Therefore, many patients will forgo treatment where they can, meaning that Europe is experiencing a large volume of unmet medical need. The WHO classifies spending as 'catastrophic' when the out-of-pocket amount a family pays for healthcare exceeds 40% of their capacity to pay for medical bills. The rate of catastrophic health expenditure varies across the EU, but the situation is most critical in Armenia, Bulgaria, Georgia, Latvia, Lithuania and Ukraine, where over 14% of households are affected by this issue.

The countries with the lowest incidence of catastrophic health expenditure, recorded below 2%, are Ireland, Slovenia, Spain, Sweden and Great Britain. The WHO also shows that in the 40 countries studied, those in the most disadvantaged households are more likely to make medical payments that eat into their spending budgets. In every country studied, the poorest 20% of households account for at least 40% of those with catastrophic health expenditures, and this number rises to over 70% in Croatia, the Czech Republic, France, Hungary, Ireland, Luxembourg, Montenegro, Serbia, Slovakia, Sweden, Switzerland, Turkey and Ukraine.

While the numbers can be partly explained by the lower incomes of the poorest households, there is an additional reason why catastrophic spending is more prevalent among this group, according to the WHO. Due to the unaffordability of treatments, disadvantaged families are more likely to delay seeking professional medical care, meaning they may have to resort to resource-intensive and expensive emergency services with the difficult conditions. In addition to measuring catastrophic spending, WHO looked at the proportion of households 'impoverished' or 'further impoverished' by medical bills. "Impoverished" means that a family's budget no longer stretches to meet basic needs, such as food or heating, after paying for medical treatment.

On the other hand, "further impoverished" is a label used to describe families who are already below the threshold of basic needs and incur an out-of-pocket health care payment, which then pushes them further into poverty. In Belgium, Ireland, Spain, Slovenia and the UK, the proportion of households impoverished or further impoverished after prior medical costs is below 1%. At the other end of the spectrum, this figure rises to over 7% in Albania, Armenia, Bulgaria, Serbia and Ukraine.

In the 40 countries studied, financial hardship is mainly caused by charges related to outpatient drugs, which account for an average of 38% of out-of-pocket payments in households with catastrophic health expenses. Other major drivers of financial hardship include outpatient dental care, outpatient medical products, and hospital care. That said, the picture changes when we look at the medical bills eating into household budgets nationally. In countries with a lower amount of catastrophic health spending, the top drivers are dental care (26%), followed by medical products (22%) and outpatient drugs (19%).

On the other hand, in countries where there is a greater connection between financial instability and health care, the leading causes of catastrophic spending are outpatient drugs (55%), followed by hospital care (13%), dental care (10%), ambulatory. care (9%) and medical products (8%). In light of the report, Dr Hans Henri P Kluge, WHO Regional Director for Europe, commented: "For millions of people in the European Region, free or affordable health care is just a dream." He continued: "Many are faced with agonizing choices such as paying for medicine or treatment at the expense of paying for food or electricity."

To prevent medical needs from driving people into poverty, the WHO stated that universal health coverage must be adequately financed by public spending. Currently, only 23 of the 40 countries studied by the WHO say they cover over 99% of the population. Among other measures, the group also suggested that access to publicly funded health care should not depend on social health insurance contributions, as this often leaves the poor vulnerable.


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