Catastrophic health care payment in Myanmar : a case study in Upper Myanmar

Out-of-Pocket (OOP) payments are the principal means of financing health care throughout much of Asia. It leaves households exposed to the risk of unforeseen expenditures that absorb a large share of the household budget. The OOP expenditures may be considered as catastrophic in the sense that they absorb a large fraction of household resources. Catastrophic impact among households in Upper Myanmar is measured by the incidence and intensity of high shares of OOP in total household money income. Concentration indices are calculated by convenient covariance method in order to find catastrophic impact matters more for poor or rich households. Households' catastrophic impacts are considerably high in Upper Myanmar. The incidence of catastrophic health care payment is 8.11, 6.59, 4.38 and 3.82 per cent for the defined catastrophic thresholds of 10, 15, 25 and 30 percent of households' income, respectively. The intensities are 4.76, 4.39, 3.84 and 3.63 percents for the same thresholds. Mean Positive Gaps are 58.7, 66.6, 87.7 and 95 percents for the four defined threshold levels. The poor households are more likely to spend a large fraction of total household resources on health care since all concentration indices indicate negative values. Because of heavy out-of-pocket health care expenditure, most of the households' income absorbed with repeated borrowing and lending mechanisms can push these households into impoverishment.