World Health Organization urges more taxes for care

The World Health Organization says spiraling health costs push 100 million people into poverty every year. Now, a report provides practical guidelines on how governments can strengthen their health financing systems and make services available to more people.

Rich and poor governments alike are struggling to pay for health care. Some people have good health plans that cover most of their expenses. But, they are in the minority.

The World Health Organization reports about one billion people in the world do not get the health services they need because they are not available or are not affordable.

David Evans, health systems financing director for the agency, says these people have a difficult choice to make. Either they pay directly for health services they cannot afford, or delay care and run the risk of getting a more serious disease.

“Probably 100 million people make the choice to use their services each year, pay for them, and they suffer the financial consequences. They are pushed down the poverty line simply because they pay for health services,” Evans said.

He adds that although this is unacceptable, there is an alternative.

“But, what the report says, it is not just acceptable, but it is not necessary. Something could be done about it, and something can be done about it now,” Evans stressed.

The report highlights three key areas of change.

It says governments can raise and allocate more money for health. For example, the World Health Organization notes, in 2000, African heads of state committed to spend 15 percent of government funds on health. So far, three countries, Liberia, Rwanda and Tanzania have achieved this.

The report says governments also could raise money more fairly and spend it more efficiently. Evans says a number of countries are adopting these options with some success.

“Gabon is a low-income country. It has introduced a tax on financial transactions, and that is going to help. If Gabon can do something like that, other countries can do it,” Evans said. “In terms of financial risk protection, Thailand has introduced health insurance for everyone, and that health insurance is tax-funded, particularly for the poor. So, that what happens is, the insurance now pays the cost that the people would have paid previously out of their own pockets.”

The report says smarter spending could increase global health coverage between 20 and 40 percent. It identifies 10 areas where greater efficiencies are possible.

One is in the purchase of medicines.

France is an example of this. It uses generic drugs wherever possible, a policy that saved the country almost $2 billion in 2008. The report says more efficient spending on hospitals could boost productivity by 15 percent.

The World Health Organization acknowledges impoverishment and financial catastrophe are more prevalent in low-income countries because people there rely more on out of pocket payments for health care. Therefore, it says, poor countries will need more help from the international community.

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