NEW DELHI: Health insurances, private and public funded, don’t provide substantial financial risk protection and nearly one-fourth of families with insurance get pushed into poverty every year following hospitalisation, says a study.
India accounts for about half of the estimated 100 million people pushed into poverty worldwide every year due to out-of-pocket expenses on healthcare, says a 2017 World Health Organisation and World Bank report.
Researchers from Chandigarh, Delhi and Gandhinagar found that hospitalization expense, was 28 per cent and 26 per cent among the insured and uninsured population respectively, which is hardly a major difference.
Consultation charges, costs of medicine and diagnosis, travelling for treatment, staying in a different city and being away from work for long due to illness, apart from hospitalisation, are other main causes of catastrophic healthcare expenditure and are not covered by health insurance.
The research is based on assessment of over 65,000 people in Haryana, Gujarat and Uttar Pradesh, who were covered under the Rashtriya Swasthya Bima Yojana (the national health insurance scheme before Prime Minister’s Jan Arogya Scheme), state government health insurance schemes, private insurances as well as families without medical insurance.
Shankar Prinja from the Post Graduate Institute of Medical Education and Research, Chandigarh, who led the study said the findings have several possible implications for PMJAY. “Scheme governance must be improved to ensure that private hospitals do not charge patients over and above what the insurance pays,” he said.