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Mark V. Pauly, Peter Zweifel, Richard M. Scheffler, Alexander S. Preker, and Mark Bassett Private Health Insurance In Developing Countries Health Affairs, March/April 2006; 25(2): 369-379. [Abstract] [Full Text] [PDF] [Media/Policy Briefing] [Reprints & Permissions]

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Saving Lives On A Dollar A Day

Peter Muennig   ( 7 March 2006 )

Saving Lives On A Dollar A Day 7 March 2006
Peter Muennig, Assistant Professor Columbia University Send letter to journal: Re: Saving Lives On A Dollar A Day pm124{at}columbia.edu Peter Muennig	In their thoughtful summary of conclusions drawn from a recent Wharton–World Bank conference, Pauly et al. note that private insurance might fill the gaps in coverage left by the public sector. Many of the countries cited in this article have relatively well-functioning public sectors but nonetheless also have a large proportion of citizens making out-of-pocket payments for medical care. To the extent that these governments are making rational resource allocation decisions, their failure to cover such medical expenses makes sense. Clean water, basic waste disposal systems, nutrition, and vaccinations should receive a higher priority than hospital care simply because such interventions save many more lives. Taking this argument one step further, it makes little sense for poor individuals to spend their precious resources on contributions to risk pools. Certainly, economic analyses are needed to test the plans these economists discuss. We also need to know whether the competing alternative is a school textbook, a nutritious meal, or a television. But on face value, the idea that hospital expenditures should be prioritized over public health interventions is probably dead wrong.