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Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India

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  • Mehtabul Azam

    (Oklahoma State University)

Abstract

Indian government launched a National Health Insurance Scheme known as Rashtriya Swasthya Bima Yojana (RSBY) in 2008 that provides cashless health services to poor households in India. We evaluate the impact of RSBY on RSBY beneficiary households' (Average Treatment Impact on the Treated) utilization of health services, per capita out-of-pocket (OOP) expenditure, and per patient OOP expenditures on major morbidities. To address the issue of non-randomness in enrollment into the scheme, we exploit the longitudinal aspect of a large nationally representative household survey data to implement difference-in-differences with matching. We find some evidence of positive impact of RSBY on utilization of health services by RSBY beneficiary households in rural India but not in urban India. However, there is no evidence that the RSBY reduced per person OOP expenditure for RSBY households in both rural and urban areas. Conditional on having received medical treatment for major morbidity, we find lower expenditure on medicine for a RSBY cardholder patient in rural areas.

Suggested Citation

  • Mehtabul Azam, 2016. "Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India," Economics Working Paper Series 1703, Oklahoma State University, Department of Economics and Legal Studies in Business.
    • Handle: RePEc:okl:wpaper:1703
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    2. Samuel Ampaw & Simon Appleton & Xuyan Lou, 2020. "Heterogeneous effect of health insurance on financial risk: Evidence from two successive surveys in Ghana," Discussion Papers 2020-04, University of Nottingham, CREDIT.
    3. Puri, Raghav & Sun, Changqing, 2021. "Increasing utilization of public health insurance programs: Evidence from an experiment in India," World Development, Elsevier, vol. 139(C).
    4. 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.
    5. Mohd Zuhair & Fuli Zhou & Saurabh Pratap & Ram Babu Roy, 2022. "Eliciting key attributes of health insurance in rural India: a qualitative analysis," SN Business & Economics, Springer, vol. 2(3), pages 1-28, March.
    6. Sengupta, Reshmi & Rooj, Debasis, 2019. "The effect of health insurance on hospitalization: Identification of adverse selection, moral hazard and the vulnerable population in the Indian healthcare market," World Development, Elsevier, vol. 122(C), pages 110-129.
    7. 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.
    8. Geng, Xin & Janssens, Wendy & Kramer, Berber & van der List, Marijn, 2018. "Health insurance, a friend in need? Impacts of formal insurance and crowding out of informal insurance," World Development, Elsevier, vol. 111(C), pages 196-210.

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    More about this item

    Keywords

    SHI; RSBY; IHDS; out-of-pocket expenditure; health services utilization;
    All these keywords.

    JEL classification:

    • I1 - Health, Education, and Welfare - - Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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