The paradox is that those who are well to do and highly influential or capable of doing damage get the services at no cost to themselves but the poor who cannot afford these services and for whom the allocation are made by the government are deprived. Access to services is rationed not by price but by the status.
What can be done to remedy this situation? Human development expenditures should be allocated in an integrated and holistic manner. Safe drinking water, more literate women and cleanliness in the neighborhoods will have high pay-off and avoid increased expenditures on curative health, population and nutrition programs.