Rising health care costs alarm WHO

Health care costs in Asia are ballooning, with poor families in some countries spending up to 30 percent of their meager household incomes on this key necessity, the World Health Organization (WHO) warns.

The problem is compounded by the lack of financial protection schemes, such as health insurance, for low-income families.

"There is a general concern that health costs are increasing rapidly and resources are not being used efficiently and effectively," laments Shigeru Omi, regional director of the Manila-based WHO Western Pacific office.

The office covers 37 countries in the East Asia and Pacific region.

Escalation in health costs is among concerns expressed by Omi in a report prepared for a five-day ministerial meeting of the WHO’s regional governing body in Kyoto, Japan from Sept. 16.

Other concerns of the region included battling poverty-linked diseases, "life-style" ailments caused by unhealthy diets and physical inactivity, and the rapidly changing role of public health systems and services.

Omi said a leading cause for increase in health care costs in developed Asian nations was excessive use of high technology medical services.

In developing countries, the health care burden on the public becomes heavier in the absence of social protection, Omi said, estimating that "20 to 30 percent" of earnings of low-income families were channeled to healthcare, including purchasing drugs.

"In such countries the current financing structure often does not provide adequate financial protection through prepayment mechanisms such as health insurance, which means all medical costs are paid for privately," he said.

Omi also cited poor management of medical facilities and services in some countries as a contributing factor to "unnecessarily high costs of basic health services."

Minor surgery, hi-tech diagnostic services and pharmaceuticals have become the main source of hospital revenue in Cambodia, China, Laos, the Philippines and Vietnam.

In Pacific island countries, he said, a high percentage of the health budget was spent on offshore referrals, some of which could be avoided if the health system were more relevant to the needs of the population.

Medical experts say that the rapid pace of privatization in Asia also contributed to the high health care costs.

Private groups were allowed to enter the crucial health sector in the region after it was discovered that state resources were not sufficient to maintain health systems, meet increased demand, and improve quality of care.

Omi said while privatization boosted efficiency in the health care sector, it also led to "profit-making, sometimes unfortunately, at the expense of the quality of services."

"That is why the government’s supervision, monitoring, quality assurance role in the health sector is so important and to ensure that health services meet national standards," he said.

Omi also said that many countries in the region lacked comprehensive, reliable and up-to-date information on financing and expenditure on health services.

Knowledge of how health services are financed is "critically important if meaningful health sector reforms are to be implemented" in the region.

Omi said to cope with rising health care costs in the region, WHO would provide technical support to countries for the strengthening of "prepayment mechanisms" through social health insurance.

"A key component of this will be reducing the financial burden of individual households caused by out-of-pocket payments," he said. — AFP