Abstract (EN)

Limited access to health care finances in developing countries results in increased “out-of-pocket” expenditures on health services. This pushes a significant percentage of the population towards impoverishment. This calls for intervention, that can lead to economic prosperity and reduce existing inequity. Can health insurance serve as a tool to finance health care to eradicate poverty? The objective of this paper is to detail the existing health insurance market for the economically weaker section in the state of Maharashtra. It attempts to find out the health status, health insurance coverage and willingness to pay for prepaid schemes in Mumbai slums and its periphery, based on a household survey done in the slums of Mumbai in 2013. The expenditure behaviour on health care reveals that out of the households that have spent a large amount on a major illness, about 32.7 per cent have had to incur out-of-pocket expenses. The penetration of health insurance is very low with only 15 per cent of the surveyed households being insured. Fifty-two per cent of the insured households show a tendency to prefer private medical institutions for treatment. Out of 85 per cent of the uninsured households, 22 per cent were willing to pay for health insurance. Results show low penetration of health insurance due to unaffordability and lack of awareness implying that there is lot of potential to develop this market.