Abstract
Globally, both public and private health care systems are facing major fiscal challenges. New technologies provide patients with more-sophisticated diagnostic and treatment methods, but they also significantly increase costs. Simultaneously, the number of patients who are elderly or have chronic diseases is surging worldwide, straining health care budgets. Paradoxically, in many countries, including emerging markets, the situation is exacerbated by an increase in wealth levels. As expendable income rises in these locations, patients are more likely to seek health care, since high copayments and out-of-pocket (OOP) expenses are less of a deterrent. Similarly, they may expect a higher quality of care, such as greater access to expensive new drugs. Even in cases in which patients pay for the majority of their treatment, payers must often cover some costs associated with the higher utilization.
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