Analyzing the Vulnerability of Catastrophic Health Expenditure in India

Poor households find it difficult to finance their health expenditure which leads to poor health and non utilization of the health care. The catastrophic payment as defined in the literature in terms of a threshold share of expenditure may not be comparable across the expenditure hierarchy rather than conceptualising the same in terms of source of financing the health expenditure. The notion of `disproportionate’ may well depend on how one finances the same? The objective of this paper is to examine the socio-economic vulnerability of the household incurring catastrophic expenditure in terms of its source of finance and role of an event in incurring catastrophic payment. Further, it also attempts to figure out the type of morbidities associated with catastrophic payment. This paper uses the National Sample Survey Organization data on Morbidity and Health Care during Junuary-June 2004. Catastrophic payment in health care need not only be based on the criterion of disproportionateness but also its source of financing, which is evident from this analysis. Further, catastrophic payments are selectively conditioned by intra-household relational domain and household vulnerabilities associated with presence/absence of children and elderly. Instead of focussing on universal health care we should focus on the most vulnerable population.