Abstract
Inadequate public spending on health care most probably is causing high morbidity and high proportion of household spending on curative health care in the poor state of Orissa. In a micro-study on morbidity, health care expense and burden on the poor in Sambalpur town, it was found that morbidity and disease prevalence rates among the poor are higher compared to that among the rich. The per capita monthly expenditure on health care is found to be as high as ₹299.57 and the median household is spending 17.91 per cent of its income on it. Households with monthly incomes of less than ₹3,000 are found spending approximately 68 per cent of their income on curative health expenditure. High out-of-pocket (OOP) spending on health care forced 21.43 per cent households to borrow; borrowing as a percentage of income is found to be 21.67 per cent on an average. The severity of the health care burden is found in the poorest. Borrowing increases the intensity of poverty and forces many non-poor/near-poor households to slip below the poverty line. The study argues for more government provision on health care to reduce the burden on the poor and to ensure equity.