The worst thing is that often it is unnecessary health expenditure, which plunge families into poverty and many health professionals simply ignore this fact. Health care, including primary health care, is becoming less patient-centered. The priorities are changing and for some health professionals nowadays patients are just their source of income and nothing else.

Here is a case history from a joint document of MSF Spain, ECHO and Georgian Ministry of Health "A Manual on Implementing Primary Health Care in Georgia"(1998): a 60-year old internally displaced man with recent stroke. He and his family were forced to sell the apartment in order to cover treatment costs. He underwent treatment with several nonessential drugs, which cost him about 542$. There is no proof that any of them is useful for the condition he had.

According to 2004 World Bank report (http://econ.worldbank.org/files/30036_ch8.pdf), 45% of rural patients in Kyrgyzstan sell assets to finance health care.