Inequality in household catastrophic health care expenditure in a low-income society of Iran

Abstract

We observed no significant change in the CHE proportion despite policy interventions aimed at reducing such expenditures. Any solution to the problem of CHE should include interventions aimed at the determinants of CHE. It is essential to increase the depth of social insurance coverage by expanding the basic benefit package and reducing co-payments.

Changes in Economic Status of Households Associated with Catastrophic Health Expenditures for Cancer in South Korea

“…These findings are in agreement with previous studies (Su et al, 2006;Kang, 2009;Song and Shin, 2010;Kavosi et al, 2012). Furthermore, Korea has a national health care system that is not connected to employment status, unlike countries such as the United States, where work decisions may be influenced by employment-connected health insurance.…”

Policy Options to Reduce Fragmentation in the Pooling of Health Insurance Funds in Iran

“…1 However, chronic maldistribution of secondary care services and hospital beds compounded with financial barriers to such services have been a continuing challenge. 2,3 As a consequence of the "Universal Health Insurance Act" in 1994, several initiatives have been conducted to increase population coverage and/or financial protection from healthcare costs. 4 As a result, Iran's population benefits from a high healthcare insurance coverage, estimated at about 83% of the population in 2010.…”

“…And finally Imam Khomeini Relief Foundation Health Insurance, which provides health insurance coverage for the poor, although the population coverage for the latter has reduced to less than 5% of the population in recent years due to the expanding reach of the IHIO. 2,4,[6][7][8][9] There are no transfers or redistribution of cross subsidy between these health insurance schemes with different population risk pools. Cross-subsidization is even limited between the insurance funds managed by IHIO.…”

“…6,11 Inefficiency in health insurance system, high out-of-pocket (OOP) expenditures, fee-for-service (FFS) payments to hospitals and physicians, a low financial protection against health services for the insured persons, considerable coinsurance rates, low contribution of well-funded institutes with generous benefit package to the public health insurance schemes, underfunding and severe financial shortages for the public funds, and a lack of transparency and not reliable data and statistics for health insurance policy-making, are some of insurance system problems that can be attributed to the fragmentation in health insurance funds directly or indirectly. 2,6,8,12 Iran's constitution (Article 2) emphasizes the importance of securing equity and justice among people in general and Article 29 explicitly notes the provision of access to healthcare and insurance as a universal right of the public. The fourth and fifth Economic, Social and Cultural Development Plans of Iran have obliged the government to ensure equity in health by providing the same basic benefit package for all Iranians.…”

Health Sector Evolution Plan in Iran; Equity and Sustainability Concerns

“…31 However, the program is expected to be more successful in decreasing catastrophic payments, because inpatient service utilization is the most important factor associated with facing catastrophic health expenditures in Iran. 32 To increase fairness, the financial contributions of people for new interventions should be progressively correlated with their income and wealth. This could lead to a positive or pro-poor redistributive effect and can be achieved through different interventions such as a designated progressive tax.…”