Potential role of health insurance in health care utilization in India: an empirical study with special reference to social health insurance

Avishek Hazra, International Institute for Population Sciences (IIPS)
Subrata Lahiri, International Institute for Population Sciences (IIPS)

Utilizing secondary dataset of WHS-2003, NFHS-3 (2005-06) and dataset of a primary survey, the present paper addresses the importance of health insurance for equitable healthcare utilization, and whether health insurance can really be a healthy option for healthcare financing in India. The paper focuses on Employees State Insurance Scheme, a social health insurance. Primary data was collected from 400 households and information regarding quality of care was gathered from 150 patients. Findings reveal that insurance coverage is very low among the people of lower income quintiles, and they spent a larger share of their income to meet healthcare costs. Although, regression analysis indicates households having any health insurance scheme tend to utilize healthcare services more compared to those without any health insurance, risk-reduction outweighs quality of care among those who are insured. Finally, the paper recommends few mechanisms how best the healthcare services can be offered to the poorer people.