Hospitalisation insurance cover found lacking in India

| 26 Feb 2019

A three-state study has revealed India's government-funded or private health insurance schemes that pay for hospitalisation have not adequately protected households from catastrophic health expenditures. This has rekindled the debate on how to achieve universal health care.

The study that examined sample households in Gujarat, Haryana and Uttar Pradesh found almost 3 out of 10 insured households and 26% of uninsured households faced catastrophic health expenditure that significantly altered their expenses on essential services, reported Telegraph India.

Their findings published in the journal PLOS One, echo long-standing concerns among sections of health experts that insurance schemes that only cover hospitalisation costs continue to expose households to significant financial risk.

The Narendra Modi government last year launched the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY) for 100,000 poor households — or 40% of the population — that pays up to INR500,000 ($7,030) per year per household for hospitalisation. The central government and the states pay the scheme’s premium on a 60:40 ratio.

The three-state study probed health-care spending by households covered by earlier government-funded schemes — such as the Centre’s Rashtriya Swasthya Bima Yojana (RSBY) that paid up to INR30,000 per year — and private health insurance.

The households covered by the Centre’s Rashtriya Swasthya Bima Yojana had the highest proportional prevalence (39%) of catastrophic health expenditure followed by households with private insurance (23%) and state insurance schemes (21%).

The study found that average out-of-pocket or personal expenditure for in-patient care among the insured was about INR32,000 and about INR24,000 for the uninsured. The average out-of-pocket expenditure was highest (INR73,000) for people enrolled under private health insurance schemes and lowest (INR15,000) for people under the RSBY.

The researchers who conducted the study said their findings — reflecting similar results from earlier studies — highlighted the need to bolster public investments in primary care.

 

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