Can government health insurance programmes improve public health?

An evaluation of the impact of expanding Rashtriya Swasthya Bima Yojana: a field experiment in Karnataka

Speaker: Prof. Anup Malani, University of Chicago
Date: June 14, 2013; 3.30-5.00 pm

India spends 4.2 per cent of GDP on healthcare. Over 60 per cent of health expenditures are private, of which a staggering 74 per cent is financed out of pocket, making it one of the highest out-of-pocket spending rates globally.

Although medical prices are comparatively low, medical inflation rates may be high and consumer credit markets are underdeveloped. As a result, medical costs impoverish an estimated 24 per cent of hospitalised Indians.

To redress the situation, the Government of India adopted the Rashtriya Swasthya Bima Yojana (RSBY) health insurance programme in 2008. When fully rolled out, it will cover 300 million of India’s poor, making it one of the largest health insurance plans globally.

But how much will the expansion of RSBY improve public health and reduce poverty, and what is the mechanism through which it does so? To answer these questions, a research team led by Anup Malani is beginning a field experiment on 9,500 households in Karnataka. The study will measure a range of outcomes from utilisation to medical debt, health behaviours to cognitive impact. It will also examine how RSBY coverage is allocated amongst members of a household.

Prof. Malani discussed the details of the experiment that is yet to be implemented. He also spoke about the policy implications of the study and sister projects that help paint a fuller picture of the value of health insurance in India.

Seminar presentation (244.8 KB)

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