MICRO HEALTH INSURANCE-AN OVERVIEW OF INDIAN SCENARIO

Abstract

The Indian health system is mainly funded by out-of-pocket payments. More than 80% of health care expenditure is borne by individual households. Only about 3% of the population, mostly those in the formal sector, benefit from some form of health insurance. Several Indian Non-Governmental Organisations (NGOs) have initiated Micro Health Insurance (MHI) schemes within their existing development programmes. This article describes the principal features of the design and functioning of few MHI schemes and presents a brief overview of the current landscape of MHI in India. The schemes explicitly target the poorest and most vulnerable households in Indian society—scheduled tribes, scheduled castes and poor women. Three MHI management models can be distinguished. The first model consists of local NGOs acting as both insurer and provider. In the second model, the NGO is the insurer but does not itself provide care, which is then purchased from a private provider. In the third model, the NGO neither does provide health care nor acts as an insurer: the NGO, on behalf of a community, links with an insurer and purchases health care from a provider.