ILLNESS TO POVERTY IN INDIA: A QUALITATIVE EXPLORATION OF HARDSHIP FINANCING FOR HEALTHCARE.

Arya Thomas, The Hong Kong University of Science and Technology
Santosh Kumar Sahu, Indian Institute of Technology Madras
Umakant Dash, Institute of Rural Management Anand

In India, regardless of the government's efforts to control health expenditures, people rely on hardship financing practices such as borrowing or selling to pay medical bills. The state of Kerala leads India in its demographic transition, resulting in a lower demographic dividend and an increased older adult population. In this context, we aim to understand how financial shocks from illnesses impact poor households in the Pathanamthitta district of Kerala. The present study seeks to investigate the effectiveness of current government insurance schemes in combating health expenditures, identify the hardship financing strategies households use, and understand the consequences of hardship financing. 50 in-depth interviews and 5 key informant interviews were conducted, and a thematic analysis was used to analyze the data. The findings show that the strategies to attenuate health costs often start with borrowing and transition to selling assets once the poverty deepens. It highlights the inability of the existing insurance to provide health protection without financially and emotionally draining the people. It also identifies the aftereffects of illness-related financial shocks, such as poverty deepening, reduced household consumption, and foregone care. The findings urge policymakers to address the issue of large expenditures on drugs despite being covered by government-sponsored insurance.

Keywords: Population Policies, Inequality, Disadvantage and Discrimination, Population and Development, Economic Demography

See paper.