IDEAS home Printed from https://ideas.repec.org/a/jfr/ijfr11/v4y2013i2p99-107.html
   My bibliography  Save this article

Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India

Author

Listed:
  • Sukumar Vellakkal

Abstract

Background &Objectives: Financial burden on households due to healthcare is high in India but only small segments of the population are covered with health insurance. This study has two objectives: 1. to investigate the factors affecting enrolment in voluntary health insurance, and 2. to examine the characteristics of enrolment in terms of income-related inequality and adverse selection problem. Data and Methods: This is a cross sectional study. Mixed method approaches- qualitative and quantitative methods- were used. In-depth interviews were conducted among officials of insurance companies, insurance consultants (insurance agents), insured and uninsured people. Subsequently, household surveys among insured and uninsured were carried to examine the significance of the determinants on enrolment. Results: In addition to income, education and health risk, the level of awareness of people about insurance and the significant role of insurance consultants matter in the enrolment in voluntary health insurance. The enrolment in health insurance is characterised by income-related inequality in enrolment, and ii) no adverse selection. Conclusion: We identified several demand and supply side factors negatively and positively affecting the enrolment. This study suggest that, in addition to developing a competitive insurance market with the availability of attractive health insurance products and ensuring reimbursement about eligible claims, appropriate policy measures such as promoting people¡¯s awareness on insurance and introducing better incentive structures for insurance consultants are needed to increase enrolment in health insurance.

Suggested Citation

  • Sukumar Vellakkal, 2013. "Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India," International Journal of Financial Research, International Journal of Financial Research, Sciedu Press, vol. 4(2), pages 99-107, April.
    • Handle: RePEc:jfr:ijfr11:v:4:y:2013:i:2:p:99-107
    as

    Download full text from publisher

    File URL: http://www.sciedu.ca/journal/index.php/ijfr/article/view/2658/1513
    Download Restriction: no
    File URL: http://www.sciedu.ca/journal/index.php/ijfr/article/view/2658
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Devadasan, Narayanan & Ranson, Kent & Van Damme, Wim & Acharya, Akash & Criel, Bart, 2006. "The landscape of community health insurance in India: An overview based on 10 case studies," Health Policy, Elsevier, vol. 78(2-3), pages 224-234, October.
    2. Dror, David Mark & Radermacher, Ralf & Koren, Ruth, 2007. "Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India," Health Policy, Elsevier, vol. 82(1), pages 12-27, June.
    3. Townsend, Robert M, 1994. "Risk and Insurance in Village India," Econometrica, Econometric Society, vol. 62(3), pages 539-591, May.
    4. Wagstaff, Adam & Lindelow, Magnus, 2008. "Can insurance increase financial risk?: The curious case of health insurance in China," Journal of Health Economics, Elsevier, vol. 27(4), pages 990-1005, July.
    5. Cameron, A. Colin & Trivedi, Pravin K., 1991. "The role of income and health risk in the choice of health insurance : Evidence from Australia," Journal of Public Economics, Elsevier, vol. 45(1), pages 1-28, June.
    6. Aradhna Aggarwal, 2010. "Impact evaluation of India's ‘Yeshasvini’ community‐based health insurance programme," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 5-35, September.
    7. Rajeev Ahuja & Johannes Jutting, 2004. "Are the poor too poor to demand health insurance?," Indian Council for Research on International Economic Relations, New Delhi Working Papers 118, Indian Council for Research on International Economic Relations, New Delhi, India.
    8. George A. Akerlof, 1970. "The Market for "Lemons": Quality Uncertainty and the Market Mechanism," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 84(3), pages 488-500.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2015. "Enrollment in Ethiopia’s Community-Based Health Insurance Scheme," World Development, Elsevier, vol. 74(C), pages 58-76.
    2. Milind Kumar Yadav & Pratap C. Mohanty, 2021. "Determinants of choice of health insurance: Empirical evidence from responses of Indian households," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1809-1829, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Macha, Raphael Rasiel, 2015. "Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania," African Journal of Economic Review, African Journal of Economic Review, vol. 3(2), July.
    2. Arnab Acharya & Sukumar Vellakkal & Fiona Taylor & Edoardo Masset & Ambika Satija & Margaret Burke & Shah Ebrahim, 2013. "The Impact of Health Insurance Schemes for the Informal Sector in Low- and Middle-Income Countries: A Systematic Review," The World Bank Research Observer, World Bank, vol. 28(2), pages 236-266, August.
    3. Sahoo, Amit Kumar & Madheswaran, S., 2014. "Out of pocket (OOP) financial risk protection: The role of health insurence," Working Papers 330, Institute for Social and Economic Change, Bangalore.
    4. Hermann Donfouet & Pierre-Alexandre Mahieu & Eric Malin, 2013. "Using respondents’ uncertainty scores to mitigate hypothetical bias in community-based health insurance studies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 277-285, April.
    5. Ketki Sheth, 2021. "Delivering health insurance through informal financial groups: Evidence on moral hazard and adverse selection," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2185-2199, September.
    6. S. Savitha & K. Kiran, 2015. "Effectiveness of micro health insurance on financial protection: Evidence from India," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 53-71, March.
    7. Raza, W.A. & Panda, P. & Van de Poel, E. & Dror, D.M. & Bedi, A.S., 2013. "Healthcare Seeking Behavior among Self-help Group Households in Rural Bihar and Uttar Pradesh, India," ISS Working Papers - General Series 50172, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    8. Catherine ARAUJO BONJEAN & Jean-Louis COMBES & Patrick PLANE, 2003. "Preserving vertical co-ordination in the West African cotton sector," Working Papers 200303, CERDI.
    9. Raj Chetty & Amy Finkelstein, 2012. "Social Insurance: Connecting Theory to Data," NBER Working Papers 18433, National Bureau of Economic Research, Inc.
    10. Bernal, Noelia & Carpio, Miguel A. & Klein, Tobias J., 2017. "The effects of access to health insurance: Evidence from a regression discontinuity design in Peru," Journal of Public Economics, Elsevier, vol. 154(C), pages 122-136.
    11. Athreya, Kartik B., 2014. "Big Ideas in Macroeconomics: A Nontechnical View," MIT Press Books, The MIT Press, edition 1, volume 1, number 0262019736, April.
    12. Hermann Donfouet & Pierre-Alexandre Mahieu, 2012. "Community-based health insurance and social capital: a review," Health Economics Review, Springer, vol. 2(1), pages 1-5, December.
    13. Sukumar Vellakkal, 2010. "Adverse Selection and Private Health Insurance Coverage in India A Rational Behaviour Model of Insurance Agents under Asymmetric Information," Working Papers id:2690, eSocialSciences.
    14. Levine, David & Polimeni, Rachel & Ramage, Ian, 2016. "Insuring health or insuring wealth? An experimental evaluation of health insurance in rural Cambodia," Journal of Development Economics, Elsevier, vol. 119(C), pages 1-15.
    15. Wameq A. Raza & Ellen van de Poel & Arjun Bedi & Frans Rutten, 2016. "Impact of Community‐based Health Insurance on Access and Financial Protection: Evidence from Three Randomized Control Trials in Rural India," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 675-687, June.
    16. Pierre-André Chiappori & Bernard Salanié, 2002. "Testing Contract Theory : A Survey of Some Recent Work," Working Papers 2002-11, Center for Research in Economics and Statistics.
    17. Raj Chetty & Emmanuel Saez, 2010. "Optimal Taxation and Social Insurance with Endogenous Private Insurance," NBER Chapters, in: Income Taxation, Trans-Atlantic Public Economics Seminar (TAPES), pages 85-114, National Bureau of Economic Research, Inc.
    18. Delavallade, Clara, 2014. "Quality healthcare and health insurance retention: Evidence from a randomized experiment in the Kolkata slums:," IFPRI discussion papers 1352, International Food Policy Research Institute (IFPRI).
    19. Owen (O.A.) O'Donnell, 2019. "Financial Protection Against Medical Expense," Tinbergen Institute Discussion Papers 19-010/V, Tinbergen Institute.
    20. Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:jfr:ijfr11:v:4:y:2013:i:2:p:99-107. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Gina Perry (email available below). General contact details of provider: http://ijfr.sciedupress.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.