Women do not avail insurance as much as men

Women from the poor and backward section of the society are way behind men when it comes to accessing the benefits from government health insurance schemes, suggests a new analysis.

"In the large underprivileged population in India with access to free hospital care, utilisation of hospital care differed for women and men. For sex-neutral conditions, women accessed a smaller proportion of care than men, suggesting that the coverage of hospital care alone is not sufficient to guarantee gender equity in access to healthcare," three researchers from the George Institute of Global Health reported in the journal BMJ Global Health.

The study that scrutinises Andhra Pradesh government's popular Rajiv Aarogyasri Community Health Insurance Scheme, comes weeks before the planned launch of the Ayushman Bharat National Health Protection Scheme, the Narendra Modi government's flagship medical insurance scheme.

Women had a lower share of hospitalisations (42%), bed-days (45%) and hospital costs (39%) for sex-neutral conditions than men, the study says. These findings were observed across 14 of 18 disease categories and all age groups, but especially for the oldest and youngest women.

"India has one of the highest levels of gender inequality in the world and as the benefits of this insurance scheme are shared within households, it could be that the healthcare needs of girls and women — particularly those not of reproductive age — are considered less important than those of their brothers, fathers and husbands," said Vivekanand Jha, George Institute's executive director in India.

The study is based on the health insurance data of 9,61,442 individuals who availed the facility between 2008 and 2012.

According to the scheme that was extended to all the 23 districts of undivided Andhra Pradesh, the beneficiary household could use free hospital service worth Rs 1,50,000 from a network of public and private hospital with an additional amount of Rs 50,000 under special circumstances.

"We have now approached the Andhra Pradesh and Telangana government to release the data after 2012 so that we can find out whether there is any change in the situation in the last five years. But it was clear that even though the burden of disease was more with women, they didn't get receive equitable healthcare," Jha told DH.

The central programme should constantly analyse the data to ensure such a gender gap didn't happen, he said.

Under the Ayushman Bharat-NHPS, the central government plans to provide Rs 5 lakh family medical insurance cover to 10.74 crore families making it the world's biggest health insurance programme.