Competition across social health insurance schemes? Evidence from India

Abstract

Out-of-pocket medical expenses continues to constitute more than 60% of all medical expenses in India even today. At the health system level, with each individual buying their health care independently implies that opportunities to exploit risk-pooling are foregone and everyone pays more for the same level of care. At the household level, buying such health costs drive households into poverty or it leads to financial barriers in accessing healthcare (Sherawat and Rao, 2012; Singh and Kumar, 2016). With widespread incidence of poverty in India, denial of access to care is widely understood problem and over the years, a wide range of government schemes have come into existence that attempt to provide access to expensive hospitalization and certain types of secondary and tertiary care (La Forgia and Nagpal 2012).