Community Health Insurance in India

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Dr. N. Devadasan Research Fellow Institute of Tropical Medicine, Antwerp AMCHSS, SCTIMST – Trivandrum.

Correspondence: C/o The Valley School Thatguni Post (Kanakapura Road) Bangalore – 560062 Tel +91 94484 91355

Overview of health insurance in India
Health care in India is financed traditionally from two sources. The government is both the funder and the provider of health care and has a wide network of primary health centres, hospitals and medical colleges. Unfortunately, the government does not allocate enough money for health – only 0.9% of the GDP. This is one of the lowest in the world and has obvious consequences. Staff is underpaid, there is not enough money to purchase medicines and buildings and equipment are usually in a state of disrepair. Hence it is not surprising that patients prefer to go the private sector for their health care needs. This also implies that they have to pay out-of-pocket for health services. This is the second form of financing health services in India. About 82% of the health care is financed in this manner, one of the highest in the world. Unfortunately, it is also the most inequitable form of financing health care. The poor end up paying more for their health care, compared to the better off. Health insurance is a possible third and more equitable option. Unfortunately, in India health insurance is still at a very nascent stage. Social health insurance covers about 35 million people through the Employees State Insurance Scheme (ESIC) and the Central Government Health Scheme (CGHS). These two schemes cover the formal sector employees and civil servants. Private health insurance is limited to the corporate sector and the upper middle class and cover less than 15 million people. Even counting those covered by employer provided services, the total number of Indians covered by any form of health security is less than 10%....
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