Illness Makes Credit Sick: Can Health Insurance Rescue the Poor from Exploitative Credit

Abstract

Health shocks cripple poor households through hardship financing and impoverishment. Borrowing from non-market sources is the most common strategy used by these households, which eventually pushes them into a debt trap. Micro health insurance (MHI) is expected to reduce the reliance on these sources of finance by ensuring financial protection. We use the data from a cross-sectional study undertaken in Karnataka to investigate any association between MHI and non-market credit during health shocks. The sample size was 1,146 consisting of 416 insured households and the remaining being uninsured. The analysis of the data shows inadequate risk protection provided by MHI giving rise to borrowing, sale of assets and liquidation of savings by insured individuals. Yet, they relied less on usurious credit compared with uninsured individuals. This finding not only substantiates the importance of MHI in health-care financing but also highlights the need for affordable and comprehensive financing mechanisms to replace non-market institutions with formal insurance. 2016 The International Association for the Study of Insurance Economics 1018-5895/16.