“All countries rely on out-of-pocket (OOP) spending to help fund their health care systems. OOP spending includes both direct payments made for uncovered services (due to lack of insurance or lacking benefits) and cost sharing requirements such as coinsurance and deductibles. It serves two main purposes: as a source of revenue, and to help reduce demand for services. However, controversy surrounds OOP payments and opponents typically voice two concerns. Charging people for their medical care means that those with the greatest need, and those with the lowest income, will feel the brunt. Moreover, patients may forgo necessary care – in contrast to other forms of financing such as taxes and premiums, which cannot be avoided by forgoing health care.”
Rice, Thomas et al. “Revisiting out-of-pocket requirements: trends in spending, financial access barriers, and policy in ten high-income countries.” BMC health services research vol. 18,1 371. 18 May. 2018, doi:10.1186/s12913-018-3185-8
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5960112/
“The final model, the out-of-pocket model, is what is found in the majority of the world. It is used in countries that are too poor or disorganized to provide any kind of national health care system. In these countries, those that have money and can pay for health care get it, and those that do not stay sick or die. In rural regions of Africa, India, China, and South America, hundreds of millions of people go their whole lives without ever seeing a doctor.”
Wallace, Lorraine S. “A view of health care around the world.” Annals of family medicine vol. 11,1 (2013): 84. doi:10.1370/afm.1484 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3596027/
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Page last updated May 25, 2020 by Doug McVay, Senior Policy Analyst.
