Financial hardship and out-of-pocket expenditure

Where health systems fail to provide adequate financial protection, people may suffer financial hardship from paying for health care, or simply not have enough money to pay for health care. As a result, lack of financial protection can reduce access to health care, undermine health status, deepen poverty and exacerbate health and socio‑economic inequalities. On average across OECD countries, just over one‑fifth of all spending on health care comes directly from patients through out-of-pocket (OOP) payments (see indicator “Financing of health care” in Chapter 7). People experience financial hardship when the burden of such OOP payments is large in relation to their ability to pay. Poorer households and those who have to pay for long-term treatment – such as medicines for chronic illness – are particularly vulnerable.