Financial Protection in Health Insurance Schemes: A Comparative Analysis of Mediclaim Policy and Chat Scheme in India

Journal of Health Management, pp. 13-25, 2012, (doi: 10.1177/097206341101400102)

14 Pages Posted: 1 May 2012

See all articles by Sukumar Vellakkal

Sukumar Vellakkal

Public Health foundation of India (PHFI)

Date Written: May 1, 2012

Abstract

This article analyzes the level of financial protection to low-income people during illness in ‘private health insurance’ and ‘people’s preferred health insurance’. In a hypothetical situation of being insured with both the pro-poor version of the ‘Mediclaim policy’ (private health insurance) and CHAT - ‘Choosing Health Plans All-Together’ - scheme (people’s preferred health insurance), this study analyzed the out-of-pocket-spending for health care incurred by persons per reported illness episodes in four select resource-poor locations in India. Three data sources were used: household survey, CHAT: a field-based experiment conducted in India to reveal people’s preference for health insurance benefits and the specification of conditions of Mediclaim policy. The study found, first, that the Mediclaim policy covers a small proportion (8 per cent) of the total reported illness episodes but CHAT scheme covers a large proportion (90 per cent) of illness episodes and, second, that the Mediclaim policy reimburses 5 per cent of the total health expenditure but CHAT scheme reimburses 37 per cent. The study concludes that private health insurance provides lower level of financial protection compared to ‘people’s preferred health insurance’ and hence recommends that health insurance packages must be comprehensive and reflect community preference to make it attractive so that health insurance penetration can be increased.

Keywords: health insurance, financial protection, health expenditure, mediclaim policy, CHAT scheme

JEL Classification: I13

Suggested Citation

Vellakkal, Sukumar, Financial Protection in Health Insurance Schemes: A Comparative Analysis of Mediclaim Policy and Chat Scheme in India (May 1, 2012). Journal of Health Management, pp. 13-25, 2012, (doi: 10.1177/097206341101400102) . Available at SSRN: https://ssrn.com/abstract=2049304

Sukumar Vellakkal (Contact Author)

Public Health foundation of India (PHFI) ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

HOME PAGE: http://www.phfi.org

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