ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Eliciting Health Insurance Benefit Choices of Low Income Groups

An appropriate scheme of health insurance must respond to clients' priorities, yet cover a finite and affordable benefit package. A variety of methods have been developed so far to engage the public in prioritising services. This paper deals with a plan that allows variably educated populations who are inexperienced with health insurance to pick health benefits. The decision exercise reported here enhances popular understanding (1) that even within a limited premium there is a choice of different package compositions; and (2) that the level of the premium determines the expectation of coverage by health insurance.

T here is a growing awareness that access to healthcare cannot be free-of-charge, due to the low level of government spending on health [Banerji 2005], nor funded mainly out-of-pocket by care-seekers, due to the regressive effect of this financing mode [James et al 2006; ODonnell et al 2005]. Notwithstanding the view that health insurance is the viable solution [Churchill 2006; ODonnell et al 2005], health insurance is nearly nonexistent in poor communities in rural India. One way of promoting the supply of health insurance for rural persons has been the Insurance Regulatory and Development Authority (IRDA) requirement that commercial insurers should satisfy rural and social quotas; another way to encourage the development of community-based micro health insurance units (MIUs) has been to include it under the governments national rural health mission [GoI 2005a], where the grassroot schemes are expected to offer essentially a complementary coverage additional to the existing government health services delivered free of charge. This would be possible, of course, only in such places where the public system is both present and trusted by the local population. In other places, the MIUs serve as substitutive schemes. Be the micro schemes complementary or substitutive, they are based on voluntary affiliation, and we assume that their main long-term source of financing is premium income. To make such programmes financially feasible, they must cover a finite benefit package that is affordable by the poor.

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