Targeting and Effects of Rashtriya Swasthya Bima Yojana on Access to Care and Financial Protection

This article provides evidence on the impact of the Rashtriya Swasthya Bima Yojana on access to healthcare and financial risk protection; its coverage across selected states and whether the targeting is effective. Overall, just about 11% of households were enrolled and almost half of these households actually belonged to the non-poor category. Although the scheme has increased hospitalisation rate, we do not know if it has enabled people to access the “genuinely needed” inpatient care which they could not afford earlier or whether hospitals are inducing the demand by suggesting unnecessary inpatient care to the people. Disturbingly, it has hardly had any effects on financial protection. These evidences unequivocally indicate that targeted health insurance coupled with a healthcare delivery system dominated by private providers cannot be the means to achieve universal healthcare.

This work was carried out while Soumitra Ghosh was visiting the Department of Economics and Business Economics, Aarhus University, Denmark as an Erasmus Mundus postdoc.

The authors sincerely thank the anonymous referee for valuable comments. They are immensely grateful to Jean Dréze who spared his valuable time in reviewing the draft version of this article and provided important insights and comments which have been incorporated into this version.