Why Publicly-Financed Health Insurance Schemes Are Ineffective in Providing Financial Risk Protection

Sakthivel Selvaraj, Anup K Karan

EPW Economic & Political Weekly,March 17, 2012 vol xlviI n 60

This paper provides early and robust evidence on the impact of publicly-financed health insurance schemeson financial risk protection in India’s health sector. It conclusively demonstrates that the poorer sections of households in intervention districts of the Rashtriya Swasthya Bima Yojna , Rajiv Aarogyasri of Andhra Pradesh, and Tamil Nadu Health Insurance schemes experienced a rise in real per capita healthcare expenditure, particularly on hospitalization, and an increase in catastrophic headcount – conclusive proof that RSBY and other state government-based interventions failed to provide financial risk protection. Therefore, the policy that is needed would aim to achieve universal health coverage of the population, moving away from the current trend of piecemeal, fragmented approaches, to providing a thrust for primary health care.


“Engaging Public Health Professionals In the Process of Change”