Reducing Health Inequalities: Kerala Cmprehensive Health Insurance Scheme a Role Model For Developing Countries

Abstract

Despite the better outcomes in certain health indicators Kerala is facing the high risk burden of chronic/non-communicable diseases among all Indian states. Recent studies show that the highest prevalence is shifting from the more affluent to the less affluent. However the main financer of health services in India is the individual household and they meet 72% of the total health care costs at the time of illness. The vulnerability of the poor and informal workers increases when they have to pay full for their medical care without any subsidy. Current usage of poverty line as the cut off for eligibility of public subsidies may not be adequate as an episode of hospitalization can bring households above poverty line below it. A large number of people borrow money or sells assets to pay for their treatment. Thus, Health insurance could be a way of overcoming financial handicaps, improving access to quality medical care, reducing inequalities in health and providing financial protection against high medical expenses. Comprehensive Health Insurance is a unique health insurance scheme introduced by Government of Kerala in 2008, expected to increase access to health care and reduce the burden of cost of treatment. The scheme was expected to cover both BPL (Below poverty line) and APL (Above poverty line) families and people who are working in informal sectors. This review paper tries to get some preliminary insights on this unique Health Insurance Scheme successfully practicing in Keral