There is growing evidence that the level of health care spending in India - currently at over 6 per cent of its total GDP - is considerably higher than that in many other developing countries. This evidence also suggests that more than three-quarters of this spending includes private 'out-of-pocket expenses'. Despite such a high share of expenditure by individuals, the provision of health care, that is adequate in terms of quality and access, is becoming more and more problematic. Particularly, public delivery of health care is poor in quality, presumably for reasons of inadequate financing. This highlights the need for alternative finances, including provision for medical insurance at a much wider level. The paper attempts to review a variety of health insurance systems in India (defined here as any mechanism which covers the risks of payment for health care at the time of its requirement), their limitations and the role of the General Insurance Corporation as an important insurer agency. It also attempts to develop a prospectus of strategy for greater regulation and increased health insurance coverage by making suitable changes - particularly in claim settlements and the exclusion clause. Also highlighted is the need for a competitive environment (which is at present completely missing), and an opening up of the insurance sector.
