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

Indrani GuptaSubscribe to Indrani Gupta

Public Financing for Health Coverage in India

Any discussion on universal health coverage in India is premature without a comprehensive understanding of public financing of health coverage in the country. This article analyses the government's share of financial resources for health across different agents, with particular focus on resources for health coverage. An attempt is made to separate spending for health in general and health coverage in particular, and to examine the issue of equity. The analysis indicates that the present health coverage system is inadequate and iniquitous, with various systems running at different costs. It suggests consolidating finances and moving towards a more unified system to realise the benefits of efficiency gains.

Health Insurance: Beyond a Piecemeal Approach

Instead of different ministries taking initiatives to provide health insurance coverage for the areas or populations that are under their jurisdiction, it is important for planners to understand that parallel schemes run on public money can only introduce inefficiencies and wastage into the system. It is necessary to plan the spread of health insurance on a national scale and to set up an apex body that would be in charge of implementing health insurance in the country.

Social Health Insurance Redefined

This paper looks at the concept of social health insurance (SHI), the form in which it currently exists in India, the issues and constraints in scaling up and innovations in SHI that may be possible in the existing system, especially in the context of other forms of health insurance. The health system in India is ripe for moving towards ?Coverage for All? which meets the ?Health for All? objective to a great extent.

Third Party Administrators

This paper attempts to understand the role of TPAs, and examines the issues that need to be taken into account while evaluating their usefulness and functioning. TPAs, in spite of their importance in enabling accessibility to insured healthcare, cannot be seen as a panacea for the problems of the health sector.The TPA system should be regulated and checked in order to ensure that consumer interest is not compromised.

Private Health Insurance and Health Costs

The IRDA Bill and the consequent opening up of the health insurance sector to foreign and private investors' raises several questions. Are Indians ready for private health insurance? Will there be demand from all sections of society? What would consumers look for when they 'purchase' insurance to cover future health risks, a concept hitherto non-existent in India? These are some of the questions this paper attempts to answer, based on data collected in Delhi from about 500 households. The study found a wide disparity across sections on willingness to participate. The challenges for the new system would be to pool individuals across risk and economic status categories; set up a multi-tier system to meet objectives of equity and efficiency in health care delivery and for planners and regulators, to keep health insurance separate from other non-health insurance.

Rural Migrants and Labour Segmentation

Whether people benefit sizeably by migrating from rural to urban areas is a question that has loomed large in development economics literature. Based on a primary survey carried out among slum-dwellers in Delhi, this study examines the links between duration of migration, distance of migration, occupation and the incidence of poverty. With experience, it is found that migrants are more likely to move from low income and casual jobs to high income and regular jobs, and thus undergo an increase in their standards of living.

Health Insurance in India

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.
Back to Top