Study on the Impact of Health Insurance on Access to Health Care

Sama undertook a detailed review of the available literature on health insurance which resulted is a working paper Health Insurance: Evaluating the Impact on Right to Health. The study aimed to review the evidence base on Social Health Insurance (SHI) in India from a right to health perspective.

The specific objectives were to review literature on SHI in India and to summarize the emerging conceptual debates and discourses underlying its potential to address the health care needs of poor populations; to critically review the evidence for community-based and SHI schemes and to assess the extent to which they address the various dimensions of the right to health care; and to highlight the policy relevance of ongoing debates and to chart future directions for research and practice.

A total of seventy-four papers, articles, reports were initially identified of which about thirty-five papers were found most relevant in the Indian context and analysed. The analysis focused on equity, examining the evidence base for the ability of the insurance model / scheme to not only make quality health care accessible and affordable for the poor(est) but also provide adequate financial protection.

The findings of the study suggested the paucity of systematic reviews and comparative assessments undertaken to either test the assumptions underlying the expansion of health insurance across India or to examine the core contents of the right to health challenging claims that insurance has an impact on equity, access, utilization, financial protection and quality of healthcare provision.

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