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

36 Pages Posted: 9 May 2016 Last revised: 12 Jun 2016

See all articles by Mehtabul Azam

Mehtabul Azam

Oklahoma State University - Stillwater; IZA Institute of Labor Economics

Multiple version iconThere are 2 versions of this paper

Date Written: May 3, 2016

Abstract

Indian government launched the Rashtriya Swasthya Bima Yojana (RSBY), a national health insurance scheme, 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 a difference-in-difference 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 that RSBY increased probability of hospitalization and being treated by a government doctor in rural areas but no significant impact in urban areas. We also find lower expenditure on medicine for a RSBY cardholder patient in rural areas.

Keywords: I1, I18, I38

JEL Classification: RSBY, IHDS, health, out-of-pocket expenditure, utilization

Suggested Citation

Azam, Mehtabul, Does Social Health Insurance Reduce Financial Burden? Panel Data Evidence from India (May 3, 2016). Available at SSRN: https://ssrn.com/abstract=2774452 or http://dx.doi.org/10.2139/ssrn.2774452

Mehtabul Azam (Contact Author)

Oklahoma State University - Stillwater ( email )

Stillwater, OK 74078-0555
United States

IZA Institute of Labor Economics ( email )

P.O. Box 7240
Bonn, D-53072
Germany

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