WHO: Lack of health insurance makes you poor

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WHO World Health Report: Lack of health insurance makes people poor worldwide.

The World Health Organization points out that more and more people worldwide are slipping into poverty due to a lack of health insurance. The treatment costs to be paid themselves often drive those affected into a debt trap from which they cannot escape without outside help.

Around 100 million people end up in the poverty trap each year due to a lack of health insurance. This affects not only developing countries but also industrialized countries such as the USA, Greece, Portugal, Poland and Hungary. The figures are based on the WHO World Health Report 2010, which is to be officially presented today in Berlin and quoted in advance from "Welt Online". Those who are not covered by health insurance are therefore at a much higher risk of poverty, since many people are simply overwhelmed with the treatment costs.

In countries without a functioning, state-subsidized health insurance system, “financial hardships” are common in the case of illness, since the people affected have to pay for their medical care themselves. However, the upcoming treatment costs are often hardly manageable for a private person, so that the WHO assumes that around 150 million people worldwide suffer from "financial catastrophes" due to insufficient coverage in the event of illness.

The WHO is therefore calling on poorer nations to increase their investments in health care. Margaret Chan, WHO Director General, urged governments to "improve health finance and strengthen health protection". According to the WHO, taxes on alcohol and tobacco could serve as counter-financing. On the one hand, this would secure financing for health care and would also have a deterrent effect on tobacco and alcohol consumption. To date, direct payments for medical treatment account for more than 50 percent of total health care expenditure in 33 countries with mainly low and middle incomes, according to the World Health Report. According to the WHO recommendation, these forms of payment should account for less than 15 to 20 percent of a country's total health expenditure.

According to the WHO, some industrialized countries also have significant health care deficits. The WHO recommends increasing the efficiency of the respective health system as the first approach to tackling the problems. Because, according to the WHO general director, for example, almost $ 300 billion is wasted annually due to inefficiency in the hospital sector. In addition, the evaluation of around 300 studies as part of the 2010 World Health Report showed that hospitals could achieve an average of 15 percent more with the same effort.

Therefore, according to the WHO, the industrialized nations should primarily try to increase the efficiency of their health systems in order to achieve better care for the population. The targeted use of certain incentives also plays a crucial role. If they are set correctly, they can significantly increase the efficiency of the health system. On the other hand, if the incentives in the national health systems are set incorrectly, they can cause undesirable developments that significantly impair efficiency, according to the World Health Report. As an example of false incentives, the WHO cites the individual remuneration for certain medical services, which leads to over-provision with the corresponding treatments. The WHO refers to caesarean sections, which are mostly paid individually and the number of which has increased in 69 of 137 countries. In the opinion of the WHO, on the other hand, the focus of medical care could be shifted to prevention with flat-rate remuneration for family doctors, for example.

In addition, according to the WHO, there is still considerable savings potential in the pharmaceutical sector in many countries. About five percent of health expenditure in industrialized countries could be saved through proper use and improved quality control of medicines, the WHO Director General said. The WHO believes that France's approach here was exemplary, and its “Generic Substitution Strategy” saved almost two billion US dollars in healthcare in 2008. Over half of all pharmaceuticals worldwide are "improperly prescribed, dispensed or sold," according to the statement in the World Health Report. The patients were often insufficiently informed about the correct intake of the preparations. According to the WHO, in the area of ​​pharmaceuticals there are still good opportunities for increasing efficiency and considerable savings potential in most countries

However, WHO not only called on industrialized countries to improve the efficiency of their health systems, but also called for them to meet their commitments to developing countries in the future. Because if all donor countries immediately fulfilled their commitments, according to the WHO, even the “Millennium Development Goals” could be achieved, which among other things should improve health care in the poorest countries worldwide. WHO could save more than three million lives by 2015. In order to be able to raise the necessary financial resources, the WHO recommends that the funds be raised in new “innovative ways”, such as through a tax on currency transactions.

With the “Millennium Goals” ten years ago, the ambitious goals by 2015 were to at least largely successfully combat extreme poverty, hunger, the mortality of millions of children and mothers as well as the epidemics of AIDS and malaria. However, the World Health Report makes it clear that these “millennium goals” in the area of ​​preventive health care have not yet been approached. Around a billion people worldwide still have no access to medical care. "For many people there is simply no health care, others cannot afford it," emphasized David Evans, director of the WHO. In Germany it is a legal requirement to have health insurance coverage. However, many small businesses in particular are still not covered by health insurance.

As part of the presentation of the WHO report, Federal Minister of Health Philipp Rösler (FDP) stated that the quality of health care is a "yardstick for social cohesion", but there are "no patent solutions" for a functioning health system. Each country is called here to find its own way and the federal government has succeeded in ensuring a sound financing of health insurance with fairly distributed burdens with its health reform, emphasized the minister. The critics of the health care reform, which have been keenly addressing the health ministers in the past few months, should see this a little differently. (fp)

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