$57B spent on drugs, dental and insurance out of pocket in 2010

Canadians' out-of-pocket spending for prescription drugs, dental care and insurance premiums rose over a 12-year period for all families, especially people with lower incomes who may have reduced their use of health-care services, a new report suggests.

Statistics Canada's report, "Trends in out-of-pocket health care expenditures in Canada, by household income, 1997 to 2009," released Wednesday shows out-of-pocket health-care spending rose.

The increase was greatest for households in the lowest one-fifth of income, Claudia Sanmartin of the agency's health analysis division and her co-authors said.

Spending for out-of-pocket expenditures, excluding insurance premiums, reached $56.9 billion in 2010, which represented about 30 per cent of health-care spending.

"In 2009, out-of-pocket health-care expenditures represented 5.7 per cent of the total after-tax income of households at the lowest end of the income distribution, compared with 2.6 per cent for households at the highest end," the authors of the report wrote. "Lower-income households were more likely than higher-income households to spend more than five per cent of their after-tax income on health care services."

About 40 per cent of households in the two lowest income groups spent more than five per cent of their total after-tax income on health-care services, compared with 14 per cent of those in the highest income group. The spending ncrease between 1997 and 2009 was greatest for households in the lowest-income group, at 63 per cent.

Throughout the study period, the three largest components of out-of-pocket health-care expenditures were:

Dental services.

Prescription medications.

Insurance premiums.

In 2009, household spending in those categories averaged $380 (dental), $320 (medications) and $650 (insurance premiums).

"Faster increases in out-of-pocket spending for lower-income households may have implications for access to health care," the report says."Lack of insurance and the burden of out-of-pocket expenditures have been associated with inequitable use of services such as dental care and prescription medications The recent trend may result in greater inequities in the use of these types of services in the future, particularly for specific low-income groups."

The survey of self-reported data covered nearly 98 per cent of the population in the 10 provinces.

Direct expenditures are those not covered by insurance, such as exclusions, deductibles and expenses over limits. The researchers also excluded reimbursed payments.

Insurance expenditures included premiums for provincial hospital, medical or drug plans, private health insurance plans, dental plans sold as separate policies, and accident or disability insurance.