IDEAS home Printed from https://ideas.repec.org/p/ind/icrier/118.html
   My bibliography  Save this paper

Are the poor too poor to demand health insurance?

Author

Listed:
  • Rajeev Ahuja

    (Indian Council for Research on International Economic Relations)

  • Johannes Jutting

    (Indian Council for Research on International Economic Relations)

Abstract

Community based micro insurance has aroused much interest and hope in meeting health care challenges facing the poor. In this paper we explore how institutional rigidities such as credit constraint impinge on demand for health insurance and how insurance could potentially prevent poor households from fallinginto poverty trap. In this setting, we argue that the appropriate public intervention in generating demand for insurance is not to subsidise premium but to remove these rigidities (easing credit constraint in the present context). Thus from insurance perspective as well, our analysis highlights the importance of having appropriate savings and borrowing instruments for the poor.

Suggested Citation

  • Rajeev Ahuja & Johannes Jutting, 2004. "Are the poor too poor to demand health insurance?," Indian Council for Research on International Economic Relations, New Delhi Working Papers 118, Indian Council for Research on International Economic Relations, New Delhi, India.
    • Handle: RePEc:ind:icrier:118
    as

    Download full text from publisher

    File URL: http://www.icrier.org/pdf/wp118.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. J. Behrman & T.N. Srinivasan (ed.), 1995. "Handbook of Development Economics," Handbook of Development Economics, Elsevier, edition 1, volume 3, number 4.
    2. Morduch, Jonathan, 1994. "Poverty and Vulnerability," American Economic Review, American Economic Association, vol. 84(2), pages 221-225, May.
    3. Zeller, Manfred & Sharma, Manohar, 1998. "Rural finance and poverty alleviation," Food policy reports 8, International Food Policy Research Institute (IFPRI).
    4. David M. Dror & Alexander S. Preker, 2002. "Social Reinsurance : A New Approach to Sustainable Community Health Financing," World Bank Publications - Books, The World Bank Group, number 15211, December.
    5. Robert Holzmann & Steen Jørgensen, 2001. "Social Risk Management: A New Conceptual Framework for Social Protection, and Beyond," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 8(4), pages 529-556, August.
    6. Mas-Colell, Andreu & Whinston, Michael D. & Green, Jerry R., 1995. "Microeconomic Theory," OUP Catalogue, Oxford University Press, number 9780195102680.
    7. Holzmann, Robert, 2001. "Risk and vulnerability : the forward looking role of social protection in a globalizing world," Social Protection Discussion Papers and Notes 23161, The World Bank.
    8. Jonathan Morduch, 1999. "The Microfinance Promise," Journal of Economic Literature, American Economic Association, vol. 37(4), pages 1569-1614, December.
    9. Holzmann,Robert & Jorgensen,Steen Lau, 2000. "Social risk management : a new conceptual framework for social protection and beyond," Policy Research Working Paper Series 21314, The World Bank.
    10. J. Behrman & T.N. Srinivasan (ed.), 1995. "Handbook of Development Economics," Handbook of Development Economics, Elsevier, edition 1, volume 3, number 3.
    11. Besley, Timothy, 1995. "Savings, credit and insurance," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 36, pages 2123-2207, Elsevier.
    12. Eswaran, Mukesh & Kotwal, Ashok, 1989. "Credit as insurance in agrarian economies," Journal of Development Economics, Elsevier, vol. 31(1), pages 37-53, July.
    13. Doris Wiesmann & Johannes Jütting, 2000. "The emerging movement of community based health insurance in sub-Saharan Africa: Experiences and lessons learned," Africa Spectrum, Institute of African Affairs, GIGA German Institute of Global and Area Studies, Hamburg, vol. 35(2), pages 193-210.
    14. Eswaran, Mukesh & Kotwal, Ashok, 1990. "Implications of Credit Constraints for Risk Behaviour in Less Developed Economies," Oxford Economic Papers, Oxford University Press, vol. 42(2), pages 473-482, April.
    15. Robert Holzmann & Steen Jørgensen, 2001. "Social Risk Management: A New Conceptual Framework for Social Protection, and Beyond," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 8(4), pages 529-556, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2015. "Enrollment in Ethiopia’s Community-Based Health Insurance Scheme," World Development, Elsevier, vol. 74(C), pages 58-76.
    2. Sukumar Vellakkal, 2013. "Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India," International Journal of Financial Research, International Journal of Financial Research, Sciedu Press, vol. 4(2), pages 99-107, April.
    3. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    4. Macha, Raphael Rasiel, 2015. "Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 3(2), July.
    5. Hermann Donfouet & Pierre-Alexandre Mahieu, 2012. "Community-based health insurance and social capital: a review," Health Economics Review, Springer, vol. 2(1), pages 1-5, December.
    6. David Mark Dror, 2018. "Health Insurance Benefit Packages Prioritized by Low-Income Clients in India: Three Criteria to Estimate Effectiveness of Choice," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 13, pages 253-270, World Scientific Publishing Co. Pte. Ltd..
    7. van Leeuwen, I.W., 2005. "Gender and microinsurance," ISS Working Papers - General Series 19175, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    8. Jacopo Bonan & Oliver Dagnelie & Philippe LeMay-Boucher & Michel Tenikue, 2012. "Is it all about Money? A Randomized Evaluation of the Impact of Insurance Literacy and Marketing Treatments on the Demand for Health Microinsurance in Senegal," Working Papers 216, University of Milano-Bicocca, Department of Economics, revised Jan 2012.
    9. Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Abebaw, Degnet & Alemu, Getnet & Bedi, Arjun S., 2019. "The impact of Ethiopia's pilot community based health insurance scheme on healthcare utilization and cost of care," Social Science & Medicine, Elsevier, vol. 220(C), pages 112-119.
    10. Koen Rossel-Cambier, 2008. "Combined Micro-Finance: Selected Research Questions from a Stakeholder Point of View," Working Papers CEB 08-004.RS, ULB -- Universite Libre de Bruxelles.
    11. Hermann Donfouet & Pierre-Alexandre Mahieu & Eric Malin, 2013. "Using respondents’ uncertainty scores to mitigate hypothetical bias in community-based health insurance studies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 277-285, April.
    12. Rajeev Ahuja, 2005. "Health Insurance for the poor in India: An analytical study," Indian Council for Research on International Economic Relations, New Delhi Working Papers 161, Indian Council for Research on International Economic Relations, New Delhi, India.
    13. Vondolia, Godwin K. & Navrud, Ståle, 2019. "Are non-monetary payment modes more uncertain for stated preference elicitation in developing countries?," Journal of choice modelling, Elsevier, vol. 30(C), pages 73-87.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Ahuja, Rajeev & Jutting, Johannes Paul, 2003. "Are The Poor Too Poor To Demand Health Insurance?," 2003 Annual Meeting, August 16-22, 2003, Durban, South Africa 25821, International Association of Agricultural Economists.
    2. Manoj Mohanan, 2008. "Consumption Smoothing and Household Responses: Evidence from Random Exogenous Health Shocks," CID Working Papers 23, Center for International Development at Harvard University.
    3. Zimmerman, Frederick J. & Carter, Michael R., 2003. "Asset smoothing, consumption smoothing and the reproduction of inequality under risk and subsistence constraints," Journal of Development Economics, Elsevier, vol. 71(2), pages 233-260, August.
    4. Robin Burgess & Rohini Pande, 2005. "Do Rural Banks Matter? Evidence from the Indian Social Banking Experiment," American Economic Review, American Economic Association, vol. 95(3), pages 780-795, June.
    5. Robert Holzmann & Steen Jørgensen, 2001. "Social Risk Management: A New Conceptual Framework for Social Protection, and Beyond," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 8(4), pages 529-556, August.
    6. Boucher, Stephen R. & Carter, Michael R., 2001. "Risk Rationing And Activity Choice In Moral Hazard Constrained Credit Markets," Staff Papers 12675, University of Wisconsin-Madison, Department of Agricultural and Applied Economics.
    7. Dercon, Stefan, 1998. "Wealth, risk and activity choice: cattle in Western Tanzania," Journal of Development Economics, Elsevier, vol. 55(1), pages 1-42, February.
    8. Karlan, Dean & Morduch, Jonathan, 2010. "Access to Finance," Handbook of Development Economics, in: Dani Rodrik & Mark Rosenzweig (ed.), Handbook of Development Economics, edition 1, volume 5, chapter 0, pages 4703-4784, Elsevier.
    9. Dyotona Dasgupta & Prabal Roy Chowdhury, 2020. "Simultaneous Borrowing and Saving in Microfinance," Discussion Papers 20-09, Indian Statistical Institute, Delhi.
    10. Somik V. Lall & Ajay Suri & Uwe Deichmann, 2006. "Household Savings and Residential Mobility in Informal Settlements in Bhopal, India," Urban Studies, Urban Studies Journal Limited, vol. 43(7), pages 1025-1039, June.
    11. Vakis, Renos, 2006. "Complementing natural disasters management : the role of social protection," Social Protection Discussion Papers and Notes 35378, The World Bank.
    12. Gashaw Tadesse Abate & Carlo Borzaga & Kindie Getnet, 2013. "Financial sustainability and outreach of microfinance institutions in Ethiopia: does organizational form matter?," Euricse Working Papers 1356, Euricse (European Research Institute on Cooperative and Social Enterprises).
    13. Hollis, Aidan & Sweetman, Arthur, 2001. "The life-cycle of a microfinance institution: the Irish loan funds," Journal of Economic Behavior & Organization, Elsevier, vol. 46(3), pages 291-311, November.
    14. Isaac B. Oluwatayo, 2004. "Income Risk and Welfare Status of Rural Households in Nigeria: Ekiti State as a Test Case," WIDER Working Paper Series RP2004-61, World Institute for Development Economic Research (UNU-WIDER).
    15. Mariapia Mendola, 2004. "Migration and Technological Change in Rural Households: Complements or Substitutes?," Development Working Papers 195, Centro Studi Luca d'Agliano, University of Milano.
    16. Anett John, 2020. "When Commitment Fails: Evidence from a Field Experiment," Management Science, INFORMS, vol. 66(2), pages 503-529, February.
    17. Skoufias, Emmanuel, 2007. "Poverty alleviation and consumption insurance: Evidence from PROGRESA in Mexico," Journal of Behavioral and Experimental Economics (formerly The Journal of Socio-Economics), Elsevier, vol. 36(4), pages 630-649, August.
    18. Richard P.C. Brown & Eliana V. Jimenez, 2008. "Remittances and Subjective Welfare in a Mixed-Motives Model: Evidence from Fiji," Discussion Papers Series 370, School of Economics, University of Queensland, Australia.
    19. World Bank, 2001. "Risk Management in South Asia : A Poverty Focused Approach," World Bank Publications - Reports 15449, The World Bank Group.
    20. Jonathan Morduch, 1995. "Income Smoothing and Consumption Smoothing," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 103-114, Summer.

    More about this item

    Keywords

    Micro-insurance; Micro-credit; Credit Constraint; Demand for Insurance;
    All these keywords.

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ind:icrier:118. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: G.K. Manjunath/A. Reddy (email available below). General contact details of provider: https://edirc.repec.org/data/icriein.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.