ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

Articles by Ajay MahalSubscribe to Ajay Mahal

Healthcare Utilisation in Rural Andhra Pradesh

The Government of Andhra Pradesh has invested in the Rajiv Aarogyasri Community Health Insurance Scheme as a means to reduce burdensome health expenses incurred by the state's below-the-poverty-line population. However, recent household data collected in two districts of AP suggest that poor patients continue to spend significantly on conditions that are not covered by the RAS at both government and private facilities. These findings suggest that the RAS alone is not likely to reduce the financial burden (of illness) on the BPL population. Instead, fundamental changes to the health system, including introduction of a gatekeeping system, may be warranted.

Decentralisation, Preference Diversity and Public Spending: Health and Education in India

Education and health are commonly devolved functions to sub-national governments, even in nations which have a unitary rather than a federal structure. This paper investigates, for the specific case of a federal country like India, whether differences between states in shares of public spending on health and education show convergence over time, and the impact of episodic horizontal partitioning of states on this process. Our analysis rejects the hypothesis that preferences for health across state level jurisdictions are becoming more uniform over time, but for education, there is evidence of convergence, albeit at a low rate.

Economic Implications of Inertia on HIV/AIDS and Benefits of Action

The HIV epidemic affects people in their most productive ages with adverse impacts on life expectancy, the productivity of the labour force and household incomes. It has not always been possible to measure the economic impact of AIDS empirically with a reasonable degree of precision. Moreover, while there is some evidence of negative individual, household and firm level impact, the empirical evidence on the impacts at the sector and national levels is still weak. While purely humanitarian considerations may be relevant in supporting investments in HIV/AIDS intervention, they may not always appear to be so for finance ministers and planners in developing countries. To justify spending more on policies to address HIV/AIDS in a regime of tight resource constraints, it is sometimes important to justify investments in AIDS prevention and treatment as being more critical relative to other investments. To the extent that HIV/AIDS has large adverse impacts on economic indicators and other socially desirable goals of society, policy action may be desirable, preferably early in the epidemic, rather than later.

Assessing Private Health Insurance in India

The entry of private health insurance companies in India is likely to have an impact on the costs of health care, equity in the financing of care, and the quality and cost-effectiveness of such care. However, an informed consumer and well-defined and implemented insurance regulation regime will ameliorate some of the bad outcomes. Regulation relating to benefitpackages, restrictions on risk selection and consumer protection would be clearly useful; also required are improved enforcement of regulatory regimes, creating large insurance buyer groups, and better coordination between IRDA and other regulatory bodies. New legislation in improving standards in health care provision may also be needed.

What Works in Alcohol Policy?

This paper empirically addresses the issue of the appropriate policy towards alcohol production and consumption in India by examining the impact of alternative policy prescriptions such as tax increases, prohibition, and the setting of age-limits on purchase on the numbers of people who report consuming alcohol. The paper suggests that an effective alternative strategy for curtailing alcohol consumption is an increase in prices, presumably via tax increases, on alcohol. If some of the tax revenues from an alcohol tax are used to school and educate the public, the gains in terms of reduced alcohol consumption rates would be even greater.
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