Financial hardship on the path to Universal Health Coverage in the Gulf States

- Policymakers are reforming their health systems towards universal health coverage.
- Borrowing for medical purposes was double that reported in OECD high-income countries.
- Half of respondents reported difficulties in obtaining support from emergency funds.
- In expanding coverage and access, those with most need maybe excluded.
- Closer attention towards the financially disadvantaged and less educated is needed.

BackgroundCountries globally are pursuing universal health coverage to ensure better healthcare for their populations and prevent households from catastrophic expenditure. The countries of the Gulf Cooperation Council (GCC) have and continue to implement reforms to strengthen their health systems. A common theme between the countries is their pursuit of universal health coverage to provide access to necessary health care without exposing people to financial hardship.MethodsUsing nationally representative data from the Global Findex study, we sought to analyze the hardship faced by individuals from four high-income countries in the GCC. We estimated the weighted proportion of individuals borrowing for medical reasons and those who are not able to obtain emergency funds. We further examined variations in these outcomes by key socioeconomic factors.ResultsWe found up to 11% of respondents borrowed money for medical purposes, double of that reported in other high-income countries. In contrast to affluent respondents, we found that respondents from deprived background were more likely to borrow money for medical purposes (adjusted odds ratio: 1.81, P < 0.001) and expected to fail in obtaining emergency funds (adjusted odds ratio: 4.03, P < 0.001).ConclusionIn moving forward with their reforms, GCC countries should adopt a financing strategy that addresses the health needs of poorer groups in their pursuit of universal health coverage.