Health spending is driving people into poverty in Europe and central Asia

“Is it acceptable that people become poor as a result of ill health?” asks Tamas Evetovits, head of the World Health Organization’s Barcelona Office for Health Systems Financing. “Acceptable or not, this is what we see across the European region.”

Increasing numbers of people in Europe and central Asia are having to spend so much on healthcare that they don’t have enough money left for their other essential needs—so called “catastrophic health spending,” which occurs when the amount a household pays out of pocket exceeds a certain level of capacity to pay. And this is becoming more and more common, says a WHO report published this week.1

“It means that once they’ve spent that much out of pocket they probably don’t have enough left to meet their other basic needs such as food, housing, and utilities,” says Sarah Thomson, senior health financing specialist at the WHO Barcelona Office for Health Systems Financing. Evetovits, Thomson, and colleagues have published the WHO report on people’s spending on healthcare in 40 countries throughout Europe and central Asia. Their analysis shows that the number of people being pushed into catastrophic health spending is rising—and not just those in poorer demographics or countries.

“Even in the richest countries in Europe, there are households that are impoverished or experiencing catastrophic health spending,” Thomson tells The BMJ. “We find consistently across countries that it’s the poorest fifth of households that are most likely to be affected.”