Tertiary care is often too expensive for people with low incomes. As a result, those with conditions requiring tertiary care often go untreated or are left with devastating hospital bills, both of which exacerbate poverty. In addition, the burden of ischemic heart disease and cancer—diseases that can potentially be dealt with in tertiary care—is rising in many countries with a lot of poverty such as China, Bangladesh, and India.
To meet the need for tertiary care while providing financial security to people with low incomes, several states in India have rolled out social insurance programs that provide free tertiary care to households below the poverty line. The authors of this research evaluated the extent to which this scheme led to changes in health outcomes and utilization among its intended beneficiaries, and they conclude that insuring poor households for efficacious but costly and underused health services significantly improves population health in India.