IDEAS home Printed from https://ideas.repec.org/p/npf/wpaper/19-283.html
   My bibliography  Save this paper

Experiences with Government Sponsored Health Insurance Schemes in Indian States: A Fiscal Perspective

Author

Listed:
  • Choudhury, Mita

    (National Council of Applied Economic Research)

  • Tripathi, Shruti

    (National Institute of Public Finance and Policy)

  • Dubey, Jay Dev

    (National Institute of Public Finance and Policy)

Abstract

The implications of expanding GSHI schemes in India has not been analyzed from a fiscal perspective. This paper analyzes the experiences of some of the early and largest GSHI schemes implemented in Indian States - in Andhra Pradesh, Tamil Nadu and Karnataka to understand the fiscal implications of initiating such schemes. We analyze three aspects: (a) the extent of fiscal burden on account of GSHI schemes and its consequences on other health expenditures, (b) the factors contributing to the extent of fiscal burden and (c) the effectiveness of spending on the schemes in terms of reducing out of pocket expenditure, extent of hospitalization coverage, and improved access to hospitalization services. Results suggest that expansion of GSHI schemes may skew expenditure away from primary and secondary care towards tertiary care, if fiscal space is limited. Although the schemes are largely dependent on private health providers for delivering services, a competitive public health system may help in containing costs and the corresponding fiscal burden. The evidence on effectiveness of public spending through such schemes has been mixed.

Suggested Citation

  • Choudhury, Mita & Tripathi, Shruti & Dubey, Jay Dev, 2019. "Experiences with Government Sponsored Health Insurance Schemes in Indian States: A Fiscal Perspective," Working Papers 19/283, National Institute of Public Finance and Policy.
    • Handle: RePEc:npf:wpaper:19/283
    Note: Working Paper 283, 2019
    as

    Download full text from publisher

    File URL: https://www.nipfp.org.in/media/medialibrary/2019/11/WP_283_2019.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Mita Choudhury & Pritam Datta, 2019. "Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat," Working Papers id:13009, eSocialSciences.
    2. Choudhury, Mita & Datta, Pritam, 2019. "Private Hospitals in Health Insurance Network in India: A Reflection for Implementation of Ayushman Bharat," Working Papers 19/254, National Institute of Public Finance and Policy.
    3. 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.
    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. Chakraborty, Lekha & Kaur, Amandeep & Shrestha, Ruzel & Jain, Komal, 2019. "Nutrition - Public Expenditure Review: Evidence from Gujarat," Working Papers 19/286, National Institute of Public Finance and Policy.
    2. Anandita Sharma, 2023. "Social Health Protection and Publicly Funded Health Insurance Schemes in India: The Right Way Forward?," The Indian Journal of Labour Economics, Springer;The Indian Society of Labour Economics (ISLE), vol. 66(2), pages 513-534, June.
    3. Patnaik, Ila & Sane, Renuka & Shah, Ajay, 2019. "Chennai 2015: A novel approach to measuring the impact of a natural disaster," Working Papers 19/285, National Institute of Public Finance and Policy.
    4. Jay Dev Dubey, 2021. "Measuring Income Elasticity of Healthcare-Seeking Behavior in India: A Conditional Quantile Regression Approach," Journal of Quantitative Economics, Springer;The Indian Econometric Society (TIES), vol. 19(4), pages 767-793, December.

    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. Anandita Sharma, 2023. "Social Health Protection and Publicly Funded Health Insurance Schemes in India: The Right Way Forward?," The Indian Journal of Labour Economics, Springer;The Indian Society of Labour Economics (ISLE), vol. 66(2), pages 513-534, June.
    2. Jaison Joseph & Hari Sankar D. & Devaki Nambiar, 2021. "Empanelment of health care facilities under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB PM-JAY) in India," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-16, May.
    3. Lekha Chakraborty & Veena Nayyar & Komal Jain, 2019. "The Political Economy of Gender Budgeting: Empirical Evidence from India," Working Papers id:13033, eSocialSciences.
    4. Anshul Kastor & Sanjay K Mohanty, 2018. "Disease-specific out-of-pocket and catastrophic health expenditure on hospitalization in India: Do Indian households face distress health financing?," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-18, May.
    5. Rinshu Dwivedi & Jalandhar Pradhan & Ramesh Athe, 2021. "Measuring catastrophe in paying for healthcare: A comparative methodological approach by using National Sample Survey, India," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1887-1915, September.
    6. Zhou, Zhongliang & Zhao, Yaxin & Shen, Chi & Lai, Sha & Nawaz, Rashed & Gao, Jianmin, 2021. "Evaluating the effect of hierarchical medical system on health seeking behavior: A difference-in-differences analysis in China," Social Science & Medicine, Elsevier, vol. 268(C).
    7. Lin, Lin & Zai, Xianhua, 2022. "The Power of Public Insurance With Limited Benefits: Evidence from China's New Cooperative Medical Scheme," GLO Discussion Paper Series 1180, Global Labor Organization (GLO).
    8. Navneet Manchanda & Dil Bahadur Rahut, 2021. "Inpatient Healthcare Financing Strategies: Evidence from India," The European Journal of Development Research, Palgrave Macmillan;European Association of Development Research and Training Institutes (EADI), vol. 33(6), pages 1729-1767, December.
    9. Uduakobong Inyang & Aniekan Etim Bassey & Agbo Ishmael Umunnakwe, 2022. "Evidence-Based Policy Evaluation: Focus on Micro-Insurance Operational Policy in Nigeria," International Journal of Finance, Insurance and Risk Management, International Journal of Finance, Insurance and Risk Management, vol. 12(4), pages 30-46.
    10. Walter Locatelli & Angela Testi & Filippo Ansaldi & Marta Giachello & Cinzia Panero & Valentino Tisa & Cecilia Trucchi, 2019. "Governance delle reti sanitarie: i Dipartimenti Inter-Aziendali Regionali (DIAR) nel nuovo sistema sanitario ligure," MECOSAN, FrancoAngeli Editore, vol. 2019(109), pages 57-81.
    11. Dupas, Pascaline & Jain, Radhika, 2023. "Can beneficiary information improve hospital accountability? Experimental evidence from a public health insurance scheme in India," Journal of Public Economics, Elsevier, vol. 220(C).
    12. Vani Kant Borooah, 2022. "Issues in the Provision of Health Care in India: An Overview1," Arthaniti: Journal of Economic Theory and Practice, , vol. 21(1), pages 43-64, June.
    13. Azam, Mehtabul, 2018. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," World Development, Elsevier, vol. 102(C), pages 1-17.
    14. 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.
    15. Uduakobong Inyang & Aniekan Etim Bassey & Agbo Ishmael Umunnakwe, 2022. "Evidence-Based Policy Evaluation: Focus on Micro-Insurance Operational Policy in Nigeria," International Journal of Finance, Insurance and Risk Management, International Journal of Finance, Insurance and Risk Management, vol. 12(3), pages 108-124.
    16. Lin Lin & Xianhua Zai, 2022. "The role of supply responses in public insurance expansion: evidence from China's New Cooperative Medical Scheme," MPIDR Working Papers WP-2022-025, Max Planck Institute for Demographic Research, Rostock, Germany.
    17. Patnaik, Ila & Roy, Shubho & Shah, Ajay, 2018. "The rise of government-funded health insurance in India," Working Papers 18/231, National Institute of Public Finance and Policy.
    18. Borooah, Vani, 2018. "Health Outcomes and Policy in India," MPRA Paper 90419, University Library of Munich, Germany.
    19. Al Dahdah, Marine & Mishra, Rajiv K., 2023. "Digital health for all: The turn to digitized healthcare in India," Social Science & Medicine, Elsevier, vol. 319(C).
    20. Rajesh Kamath & Helmut Brand & Nisha Nayak & Vani Lakshmi & Reena Verma & Prajwal Salins, 2023. "District-Level Patterns of Health Insurance Coverage and Out-of-Pocket Expenditure on Caesarean Section Deliveries in Public Health Facilities in India," Sustainability, MDPI, vol. 15(5), pages 1-17, March.

    More about this item

    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:npf:wpaper:19/283. 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: S.Siva Chidambaram (email available below). General contact details of provider: http://www.nipfp.org.in .

    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.