Assessments arise. That is health care providers may

Assessments of primary
care programs in developing countries indicated shortfalls in accessibility
services were often limited for the poor particularly in rural areas, resulting
in limited use of care.  Funding, training
and equipment deficiencies made it difficult to provide even basic
services.  Services did not meet people’s
actual needs and services in demand were not part of the basic set of
services.  In many countries, less than
half of population had access to public health services.


a typical market transaction only the bottom flow of money paid out and
services rendered takes place between the individual consumer and the
producer.  In that instance, the
consumers out of pocket price equals the full cost of the service
provided.  Buyer and the seller are
equally well informed and the buyer pays the seller directly for the goods or

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a medical market, the corresponding situations is a pre specified patient fee
paid directly to a doctor or a hospital for some predetermined and expected
quantity and quality of medical services. 
In the case of medical services, however transition is often not
anticipated and the price, quantity and quality of medical services are unknown
until after the medical event occurs. 
The transitions are unanticipated because medical illness occurs
irregularly and unexpectedly (Arrow, 1963). 
The price, quality and quantity of medical services are not known
initially because much uncertainty surrounds the diagnosis and proper treatment
of a medical problem.  In addition,
health care providers possess a greater amount of information relative to
patients regarding the provision of medical services giving rise to an
asymmetry of information.  Because no
simple relation exists between diagnosis and treatment and much is left to the
discretion of health care providers possibilities for opportunities behavior
arise.  That is health care providers may
produce more treatments or a higher quality treatment than economic considerations