Providing health insurance for catastrophic illnesses such as heart disease and cancers to people below the poverty line (BPL) in Karnataka lowered both death and out-of-pocket expenses, reported a review of a Karnataka-government health insurance programme supported by the World Bank.
For the study, published in the British Medical Journal, researchers studied nearly 80,000 households from 600 villages in Karnataka covered by the state government's Vajpayee Arogyashree Scheme (VAS).
The risk of dying from diseases covered by insurance dropped by 64%, out-of-pocket expenditure for hospitalisations dropped by 60%, and utilization of healthcare facilities increased.
Karnataka's VAS programme includes free tertiary care at both private and public hospitals empanelled by VAS; automatic enrolment of all BPL families with no annual premiums; user fees or co-payments; and health camps in rural areas by empanelled hospitals, which helped screen patients for tertiary care and transport them to hospitals in urban centres.
"The results of this study are important to India as it makes choices on how to make progress towards universal health coverage," said Onno Ruhl, World Bank Group country director for India.
"The programme shows how purchasing health services for the poorest can both improve health and provide protection from impoverishment due to out-of-pocket payments for health care," he added.
Since the programme was phased, covering poor households in the northern Karnataka in the first phase before expanding to the rest of the state, the study compared the health outcomes of roughly 45,000 households from villages that were covered by the insurance to roughly 37,000 households from villages that were not covered by the program.
The study was funded by the World Bank and led by Neeraj Sood, professor and director of research at the Schaeffer Center for Health Policy and Economics at the University of Southern California.