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Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India

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  • Sukumar Vellakkal

Abstract

Background &Objectives: Financial burden on households due to healthcare is high in India but only small segments of the population are covered with health insurance. This study has two objectives: 1. to investigate the factors affecting enrolment in voluntary health insurance, and 2. to examine the characteristics of enrolment in terms of income-related inequality and adverse selection problem. Data and Methods: This is a cross sectional study. Mixed method approaches- qualitative and quantitative methods- were used. In-depth interviews were conducted among officials of insurance companies, insurance consultants (insurance agents), insured and uninsured people. Subsequently, household surveys among insured and uninsured were carried to examine the significance of the determinants on enrolment. Results: In addition to income, education and health risk, the level of awareness of people about insurance and the significant role of insurance consultants matter in the enrolment in voluntary health insurance. The enrolment in health insurance is characterised by income-related inequality in enrolment, and ii) no adverse selection. Conclusion: We identified several demand and supply side factors negatively and positively affecting the enrolment. This study suggest that, in addition to developing a competitive insurance market with the availability of attractive health insurance products and ensuring reimbursement about eligible claims, appropriate policy measures such as promoting people¡¯s awareness on insurance and introducing better incentive structures for insurance consultants are needed to increase enrolment in health insurance.

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  • 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.
    • Handle: RePEc:jfr:ijfr11:v:4:y:2013:i:2:p:99-107
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    1. Devadasan, Narayanan & Ranson, Kent & Van Damme, Wim & Acharya, Akash & Criel, Bart, 2006. "The landscape of community health insurance in India: An overview based on 10 case studies," Health Policy, Elsevier, vol. 78(2-3), pages 224-234, October.
    2. Dror, David Mark & Radermacher, Ralf & Koren, Ruth, 2007. "Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India," Health Policy, Elsevier, vol. 82(1), pages 12-27, June.
    3. Townsend, Robert M, 1994. "Risk and Insurance in Village India," Econometrica, Econometric Society, vol. 62(3), pages 539-591, May.
    4. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    5. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
    6. Aradhna Aggarwal, 2010. "Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 5-35, September.
    7. 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.
    8. George A. Akerlof, 1970. "The Market for "Lemons": Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 84(3), pages 488-500.
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    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. Milind Kumar Yadav & Pratap C. Mohanty, 2021. "Determinants of choice of health insurance: Empirical evidence from responses of Indian households," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1809-1829, September.

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