IDEAS home Printed from https://ideas.repec.org/a/sae/sagope/v5y2015i4p2158244015614607.html
   My bibliography  Save this article

Understanding the “Cash-Less†Nature of Government-Sponsored Health Insurance Schemes

Author

Listed:
  • Priyanka Rent
  • Soumitra Ghosh

Abstract

The public health spending in India has been hovering around 1% of gross domestic product (GDP), and it contributes only 28% of total health expenditure. Hence, out-of-pocket (OOP) payments continue to be the dominant source of health care financing in India. However, for providing protection from the economic effects of health shocks, last few years have seen a plethora of central and state government–sponsored private health insurance schemes for the deprived groups, particularly those working in the unorganized sector. The latest is the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY), launched by the Government of Maharashtra in 2012. This study is an attempt to assess the extent to which RGJAY protects the families from making OOP expenditure while availing the tertiary care from the RGJAY accredited facilities. Both primary and secondary data were utilized for this study. Despite being enrolled in RGJAY, more than three fifths (63%) of the beneficiaries still incurred OOP payments for services when admitted in the hospital, and more worryingly, it was found that a significantly higher proportion of persons from Below Poverty Line (BPL) families (88.23%) reported paying for diagnostics, medications, or consumables. Furthermore, our study found that about a third of the beneficiaries experienced financial catastrophe if indirect expenditure is taken into consideration. This also implies that for the poor, ill-health has further deepened the existing poverty.

Suggested Citation

  • Priyanka Rent & Soumitra Ghosh, 2015. "Understanding the “Cash-Less†Nature of Government-Sponsored Health Insurance Schemes," SAGE Open, , vol. 5(4), pages 21582440156, November.
    • Handle: RePEc:sae:sagope:v:5:y:2015:i:4:p:2158244015614607
    DOI: 10.1177/2158244015614607
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/2158244015614607
    Download Restriction: no
    File URL: https://libkey.io/10.1177/2158244015614607?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Victoria Fan & Anup Karan & Ajay Mahal, 2012. "State health insurance and out-of-pocket health expenditures in Andhra Pradesh, India," International Journal of Health Economics and Management, Springer, vol. 12(3), pages 189-215, September.
    2. Victoria Fan, Anup Karan, and Anjay Mahal, 2012. "State Health Insurance and Out-of-Pocket Health Expenditures in Andhra Pradesh, India - Working Paper 298," Working Papers 298, Center for Global Development.
    3. Jean Drèze & Amartya Sen, 2014. "An Uncertain Glory: India and its Contradictions," Economics Books, Princeton University Press, edition 1, number 10175.
    4. Adam Wagstaff & Eddy van Doorslaer, 2003. "Catastrophe and impoverishment in paying for health care: with applications to Vietnam 1993–1998," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 921-933, November.
    Full references (including those not matched with items on IDEAS)

    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. Azam, Mehtabul, 2018. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," World Development, Elsevier, vol. 102(C), pages 1-17.
    2. Shankar Prinja & Gunjeet Kaur & Rakesh Gupta & Saroj Kumar Rana & Arun Kumar Aggarwal, 2019. "Out‐of‐pocket expenditure for health care: District level estimates for Haryana state in India," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 277-293, January.
    3. ADEBOLA, Olukemi Grace, 2020. "Universal Health Coverage In Nigeria And Its Determinants: The Case Of National Health Insurance Scheme," Academic Review of Humanities and Social Sciences, Bursa Teknik Üniversitesi, vol. 3(1), pages 97-111.
    4. Emily Gustafsson-Wright & Gosia Popławska & Zlata Tanović & Jacques Gaag, 2018. "The impact of subsidized private health insurance and health facility upgrades on healthcare utilization and spending in rural Nigeria," International Journal of Health Economics and Management, Springer, vol. 18(3), pages 221-276, September.
    5. Shankar Prinja & Pankaj Bahuguna & Indrani Gupta & Samik Chowdhury & Mayur Trivedi, 2019. "Role of insurance in determining utilization of healthcare and financial risk protection in India," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-16, February.
    6. Sulakshana Nandi & Helen Schneider & Priyanka Dixit, 2017. "Hospital utilization and out of pocket expenditure in public and private sectors under the universal government health insurance scheme in Chhattisgarh State, India: Lessons for universal health cover," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-18, November.
    7. Arindam Nandi & Ashvin Ashok & Ramanan Laxminarayan, 2013. "The Socioeconomic and Institutional Determinants of Participation in India’s Health Insurance Scheme for the Poor," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-13, June.
    8. Mohd Zuhair & Ram Babu Roy, 2022. "Eliciting relative preferences for the attributes of health insurance schemes among rural consumers in India," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 443-458, December.
    9. Saleema Razvi & Debashis Chakraborty, 2016. "Does Economic Freedom Influence Major Health Indicators in India? Cross-state Panel Estimation Results," Journal of Development Policy and Practice, , vol. 1(2), pages 203-221, July.
    10. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 32(1), pages 147-189.
    11. Arnab Acharya, 2014. "The Unburdening of Lack of Evidence," Journal of South Asian Development, , vol. 9(1), pages 27-47, April.
    12. Keane, Michael & Thakur, Ramna, 2018. "Health care spending and hidden poverty in India," Research in Economics, Elsevier, vol. 72(4), pages 435-451.
    13. Karan, Anup & Yip, Winnie & Mahal, Ajay, 2017. "Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare," Social Science & Medicine, Elsevier, vol. 181(C), pages 83-92.
    14. Mohammad Abu-Zaineh & Habiba Romdhane & Bruno Ventelou & Jean-Paul Moatti & Arfa Chokri, 2013. "Appraising financial protection in health: the case of Tunisia," International Journal of Health Economics and Management, Springer, vol. 13(1), pages 73-93, March.
    15. Phuong Huu Khiem & Yu-Chen Kuo, 2022. "Health insurance reform impact on children’s educational attainment: evidence from Vietnam," Review of Economics of the Household, Springer, vol. 20(4), pages 1255-1285, December.
    16. Sowmya Dhanaraj, 2014. "Health Shocks and Coping Strategies: State Health Insurance Scheme of Andhra Pradesh, India," WIDER Working Paper Series wp-2014-003, World Institute for Development Economic Research (UNU-WIDER).
    17. Ryoko Sato, 2022. "Catastrophic health expenditure and its determinants among Nigerian households," International Journal of Health Economics and Management, Springer, vol. 22(4), pages 459-470, December.
    18. Neelsen, Sven & Limwattananon, Supon & O'Donnell, Owen & van Doorslaer, Eddy, 2019. "Universal health coverage: A (social insurance) job half done?," World Development, Elsevier, vol. 113(C), pages 246-258.
    19. repec:eid:wpaper:3/09 is not listed on IDEAS
    20. Javkhlanbayar Dorjdagva & Enkhjargal Batbaatar & Mikael Svensson & Bayarsaikhan Dorjsuren & Munkhsaikhan Togtmol & Jussi Kauhanen, 2021. "Does social health insurance prevent financial hardship in Mongolia? Inpatient care: A case in point," PLOS ONE, Public Library of Science, vol. 16(3), pages 1-12, March.
    21. Rama Pal, 2012. "Measuring incidence of catastrophic out-of-pocket health expenditure: with application to India," International Journal of Health Economics and Management, Springer, vol. 12(1), pages 63-85, March.

    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:sae:sagope:v:5:y:2015:i:4:p:2158244015614607. 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: SAGE Publications (email available below). General contact details of provider: .

    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.