Catastrophic Medical Expenses: A Comorbidity Requiring Multilevel Intervention

Abstract

Catastrophic medical expenses are a significant yet often overlooked comorbidity, particularly in low- and middle-income countries like India. This article examines the causes, consequences, and potential solutions to mitigate the financial burden of healthcare.
Hospitalisation costs, especially for uninsured individuals, can lead to severe financial distress, pushing families into poverty. High-interest loans, often taken to settle medical bills, further exacerbate the crisis, compromising the nutritional, educational, and healthcare needs of vulnerable family members. This sets off a vicious circle of poverty and ill-health.
Public awareness and sensitisation of healthcare providers are critical, as uncompromising adherence to expensive investigation and treatment protocols may inadvertently contribute to financial ruin among vulnerable patients.
Motor vehicle accidents, a major public health issue, are a leading cause of catastrophic expenses. Young adults are frequent victims. Unfortunately they are often uninsured due to perceived low risk. Human error accounts for over 80% of road injuries, underscoring the need for public education on safe road behaviour. Lifestyle factors like tobacco and alcohol use also contribute to severe health conditions, emphasising the importance of preventive measures such as regular exercise, balanced diets, and early detection through screening.
The dilemma of ICU admissions for patients with poor prognosis highlights the need for ethical and financial sensitisation among healthcare providers. Social pressure often leads to futile ICU admissions and unaffordable treatments. Doctors must balance clinical guidelines with families’ financial realities, guiding them toward cost-effective alternatives when appropriate.
Inadequate insurance coverage and frequent claim rejections further compound the issue. Government-sponsored schemes like Ayushman Bharat Yojana aim to provide financial protection, but challenges persist. Strategies to reduce claim rejections include enhancing data accuracy, verifying eligibility, and leveraging technology.
In conclusion, addressing catastrophic medical expenses requires multilevel interventions, including public awareness, provider sensitisation, preventive healthcare, and robust insurance systems, to ensure financial protection and universal health coverage.