Catastrophic Payments and Impoverishment Due to Out-of-Pocket Health Spending: The Effects of Recent Health Sector Reforms in India

Out-of-pocket payments are the principal source of health care finance in most Asian countries, and India is no exception. This fact has important consequences for household living standards. In this paper the author explores significant changes in the 1990s and early 2000s that appear to have occurred as a result of out-of-pocket spending on health care in 16 Indian states. Using data from the National Sample Survey on consumption expenditure undertaken in 1993-94 and 2004-05, the author measures catastrophic payments and impoverishment due to out-of-pocket payments for health care. Considerable data on the magnitude, distribution and economic consequences of out-of-pocket payments in India are provided; when compared over the study period, these indicate that new policies have significantly increased both catastrophic expenditure and impoverishment.