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

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Publicly-Financed Health Insurance Schemes

Furthering the debates on the impact assessment of publicly-financed health schemes, a response to two issues raised by Sukumar Vellakkal and Shah Ebrahim (EPW, 5 January 2013).

Why Publicly-Financed Health Insurance Schemes Are Ineffective in Providing Financial Risk Protection

This paper provides early and robust evidence on the impact of publicly-financed health insurance schemes on financial risk protection in India's health sector. It conclusively demonstrates that the poorer sections of households in intervention districts of the Rashtriya Swasthya Bima Yojna , Rajiv Aarogyasri of Andhra Pradesh, and Tamil Nadu Health Insurance schemes experienced a rise in real per capita healthcare expenditure, particularly on hospitalisation, and an increase in catastrophic headcount - conclusive proof that RSBY and other state government-based interventions failed to provide financial risk protection. Therefore, the policy that is needed would aim to achieve universal health coverage of the population, moving away from the current trend of piecemeal, fragmented approaches, to providing a thrust for primary health care.

Deepening Health Insecurity in India: Evidence from National Sample Surveys since 1980s

Drawing on evidence from the past morbidity and health surveys (1986-87 to 2004) and consumer expenditure surveys (1993-94 to 2004-05) of the National Sample Survey Organisation, this paper argues that public provisions of healthcare in India has dwindled to new lows. Outpatient and hospitalisation care in India in the past 20 years has declined drastically, leading to the emergence of private care players in a predominant way. While healthcare costs have shot up manifold in private provisioning, government health facilities are increasingly compelling patients to look for private outlets for procuring drugs and diagnostics. Due to these developments, millions of households are incurring catastrophic payments and are being pushed below poverty lines every year.
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