Impact of CBHI on self-medication: In our dataset, we observed a common denominator to the three study locations in that people self-medicated, which was at least in part independent of the composition of the benefits package.For those who wish to implement a new CBHI or wish to make improvements in existing CBHI schemes, or health policymakers wondering whether such schemes should be supported, there is an extremely limited evidence base on which to make decisions. Trop Med Int Health. The Marketing Challenge Successful marketing of CBHI programs generally requires a preexisting network of grassroots beneficiaries and persistent teams of outreach workers with deep knowledge of local traditions. While the programs have small premiums—as little as the equivalent of 50 cents per year—their promoters have large ambitions: to improve access to health care and avert the crushing debt that often accompanies serious illness. This assumption was inoperable, as many households in the control groups wanted to join instantly, and many in the treatment cohorts did not join. Risk Manag Health Policy. This introduced a limitation on impact evaluation. Seshadri visited the Mysore pilot, which placed a claims office inside government hospitals—enabling field workers to regularly interact with patients, their families, and hospital administrators. Management and underwriting also remain thorny issues, with the efforts of NGOs, private insurers, and government health systems often failing to mesh and programs falling deep into the red. In April , after ICICI Lombard General Insurance became a partner in the Dharmasthala initiative, the company slashed the number of participating hospitals from 80 to 35—focusing on the most reliable facilities—and launched a preauthorization scheme for planned surgeries. As our intervention required that the insured group would be involved in the design and pricing of their benefits packages, it was foreseeable that each of the three CBHI schemes might choose a different benefits package.
The impact of health insurance schemes for the informal sector in low- and middle-income countries: A systematic review. Financial protection - Quintile movement of MPCE non-health : Financial protection was reflected not only in absolute terms but also in the relative position of a household compared to others in the same community.
Since the relevant unit for borrowing-with-interest was the HH, we compared borrowing of insured HHs i.
Health Policy. PLoS One. The CRCT rules assumed that enrollment decisions would be en-bloc which could be quasi-involuntary : all members of each SHG, along with all the members of their HHs, would have to join the insurance as a group, or not enroll at all.
Seshadri visited the Mysore pilot, which placed a claims office inside government hospitals—enabling field workers to regularly interact with patients, their families, and hospital administrators.
Such heterogeneity restricted the choice of indicators for the impact evaluation. But challenges remain in transforming these piecemeal pilot efforts into large-scale programs that can address the vast populations without health coverage.Post-intervention , the DiD value was negative in Pratapgarh and Vaishali, suggesting that the insured group was less likely to self-medicate than the uninsured, but the difference was not significant. Social consequences Some authors suggested that the schemes may also have less tangible impacts on the insured. It would be interesting to study the NGO-intermediated schemes to see whether these schemes end up generating profits or losses for the GIC. Health Econ. To optimize risk-sharing, it is desirable that the schemes attract heterogeneous populations in terms of demographic variables such as age, gender, occupation, etc. Green D. From an ethical perspective, the use of CRCT in our experiment implied withholding access of some people to benefits, and thus may not be the most suited research design. Borrowing to cope with adverse health events: liquidity constraints, insurance coverage, and unsecured debt. Pal R. Families were being impoverished or indebted because of medical expenses. Quite possibly, given that most of the schemes provide fixed indemnity coverage, and many provide reimbursement only after the insured has paid for the hospitalization out-of-pocket, so people may still avoid hospitalization for fear that all their costs may not be covered.