Out-of-pocket spending

Reduce out-of-pocket spending, especially by the poor Expand health insurance through national, local and employer schemes... 

Out of pocket spending is a result of failure by the government to allocate sufficient financial resources for medicines supplies essential for treating prevailing diseases for the majority of the population. Patients therefore have to buy all medicines they need from the private sector. 

Note Equivalent to 750 In out-of-pocket spending. Equivalent to 3,600 in out-of-pocket spending... 

In 1960,49% of health care revenues came from out-of-pocket payments from individuals. Out-of-pocket spending is defined as expenditures for coinsurance and deductibles required by insurers, as well as direct payments for services, which are covered by a third party. In 1990, individual consumers spent 144.4 billion ectly for out-of-pocket payments for personal health ser-vices.f This accounted for 38% of all personal health spending. In 1998, consumers spent 183.7billion in out-of-pocket payments, which accounts for 33% of the 558.7 billion in personal health spending. ... 

In the poorest countries, the "public" system is really a mixture of publicly funded staff and consumables funded privately through out-of-pocket spending by patients. In many countries, staff also expect informal "fees" in return for access to health care. As a result, the cost-effectiveness of service delivery is low, and services are consumed by relatively well-off patients with less urgent health needs, undermining both the efficiency and equity of the health system. 

N. Nazmi Sari and J. Langenbrimner, Consumer out-of-pocket spending for pharmaceuticals in Kazakhstan implications for sectoral reform. Health Policy and Planning 16(4) (2001), 428-434. 

Sustainable financing can also be achieved by a combination of several viable financing mechanisms, including, in addition to the above, reallocation of public funds, better use of out-of-pocket spending, and international financing through grants, donations, and loans under appropriate circumstances. 

Patients, as all consumers, want to receive the most value in products or services for the dollars they spend. Within a prescription drug benefit program, patients, as consumers, want to receive a convenient and effective treatment for the lowest out-of-pocket cost. In addition, they and their physicians expect little hindrance in providing and receiving prescribed treatments. Not encumbered by price they look for fhe mosf value, which frequently translates into the latest medication with its perceived greater value. They also want the largest quantity possible and the most medication for each plan copayment or coinsurance cost at the pharmacy. 

The Tanzanian and Kenyan health sectors, like many others in Africa, rely heavily on private individual expenditure for financing hence, fees and charges operate as barriers to access to adequate health care for much of the population (Chuma and Okungu, 2011 Maluka, 2013). WHO data for 2012 estimate that private out-of-pocket (OOP) spending funded 48% of Kenyan health care, with another 6% from private insurance. The hgures for Tanzania were 32% OOP, with negligible private insurance. Charges are applied quite widely in the public as well as private sectors in both countries. 

But no one who is a chemist at heart can resist the elements, and that includes me. It includes Oliver Sacks too, who as a boy set about collecting the elements as most other boys collected stamps or coins. He wanted to own them all. In the 1940s it was not so hard to add to one s collection Sacks could go to Griffin Tatlock in Finchley, north London, and spend his pocket money on a lump of sodium, which he would then send fizzing over the surface of Highgate Ponds near his home. I envy him the best I could do was to smuggle lumps of sulphur and bottles of mercury out of the school laboratory. 

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