Designing health plan benefits: a simulation exercise

Keefe, Carole; Goold, Susan Dorr

doi:10.1111/j.1365-2929.2004.02001.x

Cited by 4 publications

(1 citation statement)

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“…It deals with the fundamental economic problem of reconciliation of limited resources and unlimited desires (for more details of CHAT tool, see Danis et al 2007). The CHAT tool used in India was a revised version of the original CHAT tool developed and tested in the USA (Danis et al 2002(Danis et al , 2004Goold et al 2005;Keefe and Goold 2004) which was then adapted to the Indian situation. It revealed that the poor will make a careful selection of benefits if they get an opportunity to reveal their preferences (Danis et al 2007;Dror et al 2007a).…”

Section: Chat Scheme and Mediclaim Policymentioning

confidence: 99%

Financial Protection in Health Insurance Schemes: A Comparative Analysis of Mediclaim Policy and CHAT Scheme in India

Vellakkal

2012

Journal of Health Management

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This article analyzes the level of financial protection to low-income people during illness in 'private health insurance' and 'people's preferred health insurance'. In a hypothetical situation of being insured with both the pro-poor version of the 'Mediclaim policy' (private health insurance) and CHAT-'Choosing Health Plans All-Together'-scheme (people's preferred health insurance), this study analyzed the out-of-pocket-spending for health care incurred by persons per reported illness episodes in four select resource-poor locations in India. Three data sources were used: (a) household survey, (b) CHAT: a field-based experiment conducted in India to reveal people's preference for health insurance benefits and (c) the specification of conditions of Mediclaim policy. The study found, first, that the Mediclaim policy covers a small proportion (eight per cent) of the total reported illness episodes but CHAT scheme covers a large proportion (90 per cent) of illness episodes and, second, that the Mediclaim policy reimburses five per cent of the total health expenditure but CHAT scheme reimburses 37 per cent. The study concludes that private health insurance provides lower level of financial protection compared to 'people's preferred health insurance' and hence recommends that health insurance packages must be comprehensive and reflect community preference to make it attractive so that health insurance penetration can be increased.

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