The Diverse Effects of Government Sponsored Health Insurance and the Role of Public Hospitals in Kerala

The Kerala model of development, founded on ‘good health at low cost’ in the 1970s, was seriously threatened by economic, social, demographic, and epidemiological transitions in Kerala, leading to ‘poor health at exorbitant cost’ by the early 2000s. To tackle these exorbitant healthcare costs, mainly precipitated by a reliance on private hospitals, the state government partnered with the central government to introduce various Government-Sponsored Health Insurance (GSHI) schemes. This study traces the diverse effects that the state policy might have created in Kerala by using GSHI as a mechanism to divert the GSHI-covered households towards public hospitals between 2008 and 2020.