Impacts on personal financial situation
A health intervention may have a financial impact on individuals and families. People may have to pay out of pocket costs to receive care. A core principle of Universal Health Coverage, by which we are guided, is that every person in the country should be able to access quality health care without having to suffer financially for it. A health intervention may also reduce financial hardship if illness or disability keeps people from being able to work and earn income.
To assess whether covering an intervention will change individuals’ or their families’ financial circumstances, consider how covering of an intervention can result in:
Direct out-of-pocket expenses for individuals and their families
- If the intervention is covered, would it result in a significant impact on the person and their family’s experience of poverty? For example:
- Does the intervention address a chronic health need requiring frequent out-of-pocket payments, which may be keeping individuals or families stuck in poverty?
- Is the expense associated with health intervention so high that, if not covered, it would drive most into poverty?
High out-of-pocket costs also raise Equity considerations as some poorer individuals or households may choose not to seek care at all, while the wealthy are able to pay
Indirect financial benefits on individuals and their families
- If the intervention is covered, how would it change the ability to earn a living for those affected or their family members?
There are often links between Respect & Dignity and people’s experience of poverty or their ability to work. Interventions that reduce poverty or enable people to earn a living likely also have related positive impacts on Respect & Dignity.
Personal Financial Situation and Systems Factors & Constraints
In the real-world context of the health system & other factors
- Does the intervention have any specific advantages or disadvantages based on systems factors and constraints that are relevant to out-of-pocket payments for those seeking care, such as changes in required frequency, distance, or cost of transport?
- Do the underlying systems factors and constraints impact how the intervention may increase or decrease the ability of patients to participate in income-generating activities, including the time needed to seek and receive services that could otherwise have been spent working?