Health insurance and health care in India: a supply-demand perspective

India’s health care and health financing provision is characterized by too little Government spending on health, meager health insurance coverage, declining public health care use contrasted by highest levels of private out-of-pocket health spending in the world. To understand the interconnectedness of these disturbing outcomes, this paper envisions a theoretical framework of health insurance and health care revisits the existing health insurance schemes and assesses the health insurance cover in relation to the pattern of health care use using data from myriad official statistics and the recent NFHS, 2005-06. Theoretical exploration of the axis of supply-demand determinants unfolds that a complex of factors such as sparse health financing options, self-obstructing heavily risk protected insurance market and weak consumer demand contribute to the measly level of health insurance penetration in India. Health insurance cover is found to be a strong determinant of modern health care use. Regional and rural-urban disparities in health insurance and health care are significant. Health insurance coverage is positively related while public health care use is negatively related with household economic condition and education status. The complex axis of critical supply side imperfections and considerable demand side weaknesses necessitate a major health care reform with the viable financing and health care options