“Health Insurance for Health Financing”: Strategy to Deal with Medical Poverty among Urban Poor in India

Shrikant Singh, International Institute for Population Sciences (IIPS)

Under utilization of public health facilities and heavy out-of-pocket expenditure create two potentially competing challenges- strengthening urban health delivery system and rolling out of state sponsored health insurance. This paper analyzes barriers in coverage of health insurance with possible hybrid solutions to address medical poverty, using data from 5720 HHs from three Indian cities. Urban poor are highly deprived in health insurance coverage as the adjusted effects of slum residence portrays that those in Jaipur and Pune are 0.57(p<0.05) and 0.63(p<0.05) times less likely to be covered despite a considerable proportion of them visiting private health facilities for general health as well as for MNCH. Major barriers in enhanced coverage of health insurance are lack of awareness of protocols and low perceived quality of such schemes. These findings demand for widening coverage of health insurance, through promoting public private partnership with a provision of administrative quality control with vertical accountability.