Inflation and war threaten the financial security of millions of people in the European Region. On Universal Health Coverage Day (12 December), WHO/Europe is calling on countries to learn from previous shocks and prevent out-of-pocket payments for health care from plunging people into poverty. poverty this winter.
Data shows that after the economic crisis that followed the global financial crisis of 2008, cuts and slowing growth in public health spending led to staff shortages, longer waiting times and restrictions on coverage in many countries in the European Region, widening inequalities in affordable access to health care. For example, 6 countries have limited the right to state-funded health care, generally affecting people in precarious situations; 17 countries have reduced the scope of health benefits; and 24 countries increased user fees (co-payments).
In countries with the tightest health budgets, the share of people foregoing health care because of cost has doubled, and financial hardship caused by out-of-pocket payments has also increased, according to analysis by the Bureau. Health Barcelona of the WHO. Funding of systems.
Even before the current shocks, out-of-pocket payments for health care pushed as many as 1 in 10 households into poverty – or more into poverty – in some countries in the Region. In addition, 1-19% of households (depending on the country) incurred catastrophic health expenditures (out-of-pocket payments that exceeded 40% of the household’s remaining income, once basic needs were met), which meant that they did not could no longer provide for other basic needs such as food, shelter and heating.
As the European Region grapples with war, the cost of living crisis and rising energy prices, WHO/Europe urges countries to learn from the lessons of the 2008 financial crisis, to increase public health spending and to prioritize the protection of those most in need, which is now more important than ever.
Protect low-income people
Research shows that low-income people are the most likely to experience catastrophic out-of-pocket payments, primarily due to spending on drugs and medical products.
“Financial hardship can force people to choose between feeding their families, heating their homes or getting the medicines they need,” said Dr Hans Henri P. Kluge, WHO Regional Director for Europe. “Building a healthier society means that governments invest in health systems, especially in times of crisis, to ensure health for everyone, everywhere.”
To sustain progress towards universal health coverage, countries need to address health coverage gaps that typically affect low-income households. For example, they must ensure that:
national health insurance schemes cover people in informal or precarious work;
state-funded health benefits include a wide range of outpatient drugs;
low-income people are exempted from paying health care user fees, in particular user fees for outpatient medication;
administrative barriers do not prevent people from accessing the services to which they are entitled.
Protecting people affected by conflict
In the context of the war in Ukraine, people fleeing the conflict must have access to the full range of health services, including medicines, without administrative, communication or financial obstacles.
The provision of health care to refugees can have a significant impact on the health budgets of host countries. This pressure can be alleviated by allocating additional public funds to meet increased health needs. Greater external funding, particularly for middle-income countries and those hosting large numbers of refugees, would allow for more effective support.
For those who remain in Ukraine, ensuring affordable access to health care is a challenge. The war is likely to reverse Ukraine’s progress towards universal health coverage due to the deteriorating economic situation of most households.
However, changes to health financing policy, including coverage policy, may mitigate the effects for those in need. People pushed into poverty by conflict must be protected from financial barriers and catastrophic out-of-pocket payments, especially older people with chronic illnesses.
WHO/Europe is providing technical support to Ukraine in this area.
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