How Affordable Is Private Medical Care

World Bank and WHO: Half the world lacks access to essential health services, 100 million still pushed into extreme poverty because of health expenses


Issue of affordability health care cost- low middle income countries

Healthcare is an essential aspect of human life. Healthcare must be Affordable and Accessible, but also High Quality. However, the high cost of healthcare services has made it unaffordable for many people, especially in low- and middle-income countries. Private medical care, in particular, is usually expensive and out of reach for many individuals and families. This article will explore the challenges of affordability in private medical care in low- and middle-income countries (LMICs) and potential solutions to address these challenges.


Challenges of Affordability of Healthcare in LMICs

The primary challenge for affordability of healthcare in LMICs is the lack of adequate public healthcare infrastructure. The state-run hospitals are running with shortages id Medicine; state of art equipment; personalised patient care, long dates of appointments, and queues and accessibility to Medical practitioners of choice. In many LMICs, public healthcare facilities are underfunded, understaffed, and often lack essential equipment and supplies. Private medical care is often the only option available to people living in these countries. As a result, people often turn to private healthcare providers for their medical needs, which can be significantly more expensive than public healthcare.


In low- and middle-income countries, private medical care can be particularly unaffordable for many people. The high cost of private medical care is due to several factors, including the high cost of medical equipment, salaries for healthcare workers, and the cost of medical research and development. Affordability of healthcare costs is a major concern in low and middle-income countries. Additionally, private healthcare providers are often concentrated in urban areas, making it difficult for people in rural areas to access quality healthcare.


One of the main challenges of affordability in private medical care in low- and middle-income countries is the lack of health insurance. Many people in these countries do not have access to health insurance, and therefore have to pay for healthcare services out of pocket. This can be a significant financial burden, especially for people with chronic illnesses that require ongoing medical care.





Potential Solutions to Address Affordability in Private Medical Care

There are several potential solutions to address the challenges of affordability in private medical care in low- and middle-income countries. These include:

High out-of-pocket costs for healthcare in LMICs: Unlike many high-income countries where healthcare is provided through government-funded systems, in LMICs, patients are required to pay for their healthcare costs out-of-pocket. This means that even routine medical procedures can be a significant financial burden for low and middle-income families, which can often lead to delayed treatment and even worsened health outcomes.


Encouraging the Development of Health Insurance

One of the most effective ways to make private medical care more affordable in low- and middle-income countries is to encourage the development of health insurance. Health insurance can help to spread the cost of medical care across a wider population, making it more affordable for everyone. Governments can work with private insurance providers to develop affordable health insurance plans that are accessible to low and middle-income families. Additionally, governments can subsidize insurance premiums to make it even more affordable for people to enroll in these programs. Governments can play a role in encouraging the development of health insurance by offering tax incentives to insurance providers and making it mandatory for employers to provide health insurance to their employees.


PMJAY is a game changer in this direction if implemented truly without scams and scandals, Ayushman Bharat, a flagship scheme of Government of India, was launched as recommended by the National Health Policy 2017, to achieve the vision of Universal Health Coverage (UHC). This initiative has been designed to meet Sustainable Development Goals (SDGs) and its underlying commitment, which is to “leave no one behind.” Ayushman Bharat is an attempt to move from a sectoral and segmented approach of health service delivery to a comprehensive need-based health care service. This scheme aims to undertake path breaking interventions to holistically address the healthcare system (covering prevention, promotion, and ambulatory care) at the primary, secondary and tertiary level.


Regulating Prices of Provision of care

Another challenge of affordability in private medical care in low- and middle-income countries is the lack of price regulation. Unlike in high-income countries, where there are strict regulations on the prices of medical services and drugs, private medical providers in low- and middle-income countries can charge whatever they want. This often leads to exorbitant prices that are out of reach for many people. To address affordability in private medical care is to regulate prices. Governments can set price ceilings for medical services and drugs, medical diagnostics and interventions (surgical or Medical or radiological or Minimum access or endoscopic or robotic) which can help to prevent private medical providers from charging exorbitant prices. This can be done through the establishment of a regulatory body that is responsible for monitoring prices and enforcing regulations.




Investing in Healthcare Infrastructure

Investing in public healthcare infrastructure is a critical first step in addressing the affordability of healthcare in LMICs. Governments can prioritize healthcare spending and allocate resources towards building and improving public healthcare facilities. This would not only provide affordable healthcare options for people but also create job opportunities for healthcare professionals in rural areas.


There is a lack of investment in healthcare infrastructure in many low- and middle-income countries. This means that there are few private medical facilities and providers, and those that do exist are often located in urban areas. This makes it difficult for people living in rural areas to access private medical care, which can be a major obstacle to receiving essential medical services. Investing in healthcare infrastructure is another potential solution to address affordability in private medical care. This can involve building new medical facilities in rural areas, where there is a lack of access to private medical care. Governments can also invest in training healthcare workers to ensure that there are enough qualified professionals to provide medical services in these areas.


Encouraging Telemedicine

Telemedicine is a rapidly growing industry that has the potential to provide affordable healthcare options for people in LMICs. Telemedicine involves the use of technology to provide remote medical consultations and diagnoses. By leveraging technology, people in rural areas can access medical care from qualified professionals without the need to travel long distances or pay high fees for private healthcare. Governments can invest in the necessary infrastructure to support telemedicine and provide training for healthcare professionals to use these technologies effectively.


Encouraging Medical Tourism

Encouraging medical tourism is another potential solution to address affordability in private medical care in LMICs. Medical tourism involves traveling to another country to receive medical treatment. This involves promoting private medical facilities to people living in high-income countries who are looking for more affordable medical services. This can help to attract foreign investment into the healthcare sector, which can be used to improve healthcare infrastructure and make private medical care more affordable for local populations Many LMICs have established themselves as medical tourism destinations, offering high-quality medical care at significantly lower prices than in high-income countries. By promoting medical tourism, governments can attract foreign patients and generate revenue that can be used to support public healthcare infrastructure and provide affordable healthcare options for residents

Reducing Drug Prices and Promoting the Use of Generic Drugs


Finally, promoting the use of generic drugs is another potential solution to address affordability in private medical care.  High drug prices are a significant barrier to accessing healthcare in LMICs. Governments can work with pharmaceutical companies to negotiate lower prices for essential drugs. Additionally, governments can promote the use of generic drugs, which are often significantly cheaper than brand-name drugs but are equally effective in treating many medical conditions.



The affordability of healthcare costs in LMICs is a complex challenge that requires a multifaceted approach. Governments must prioritize healthcare spending and invest in public healthcare infrastructure, promote health insurance, encourage telemedicine, reduce drug prices, and promote medical tourism. By implementing these solutions, it is possible to provide affordable healthcare options for people in LMICs, improve health outcomes, and promote economic growth.


(Dr Fiaz Fazili is a Senior Consultant Surgeon and Clinical auditor with expertise on Healthcare (Hospital policy planning and Quality management & Hospital performance improvement projects)


By admin