Health insurance no guarantee for diabetes care in developing countries

Even with insurance, many diabetics in developing countries are failing to get essential medications that could help them manage their condition. As a result, the burden of catastrophic spending could increase. In addition, countries like China and India are not fully prepared to deal with the rising trend of diabetes.

This alert is carried in a report on the website of the Freeman Spogli Institute for International Studies at Stanford University. The report quotes Jeremy Goldhaber-Fiebert, an assistant professor of medicine, as having said that in many cases, people are spending a great deal of their household incomes to pay for treatment for diabetes.

Using responses to a global survey conducted by the World Health Organization in 2002 and 2003, Prof Goldhaber-Fiebert and his research team examined data from 35 low- and middle-income countries in Asia, Latin America, Africa and Eastern Europe to determine whether diabetics with insurance were more likely to have medication than those without insurance.

They also wanted to know whether insured diabetics have a lower risk of “catastrophic medical spending,” a term the researchers define as spending more than 25% of a household income on medical care.

However public and private health insurance programmes are not providing sufficient protection for diabetics in many developing countries, says Prof Goldhaber-Fiebert. “People with insurance aren’t doing markedly better than those who don’t have it.”

He added: “They were also no less likely to suffer catastrophic medical spending.” He added that health insurance and health systems need to be re-oriented to better address chronic diseases like diabetes.

There are many reasons why health insurance may not protect diabetics in developing countries against high out-of-pocket spending. In some cases, there is a lack of sufficient medication – such as insulin – that regulate glucose levels.

Without those drugs, there is a greater risk of complications that often lead to more hospitalisations and more expenses. In other cases, co-payments and deductibles are too high. Sometimes, drugs and medical services to prevent diabetes complications are not covered. In addition, doctors and hospitals in developing regions do not always accept insurance.