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

Laveesh BhandariSubscribe to Laveesh Bhandari

The Impoverishing Effect of Healthcare Payments in India: New Methodology and Findings

The paper reflects the personal views and analysis of the authors and not the official views of the World Bank or its affiliates. The authors gratefully acknowledge the financial support of the World Bank and Department for International Development for this work.Peter Berman ( pberman@worldbank.org ) is with the Health Nutrition and Population Unit of the World Bank, Washington DC, Rajeev Ahuja ( rahuja@worldbank.org ) is with HNP Unit of the World Bank, New Delhi and Laveesh Bhandari ( laveesh@indicus.net ) is with the Indicus Analytics, New Delhi. High private healthcare spending as well as high out of pocket spending in India are placing a considerable financial burden on households. The 60th national morbidity and healthcare survey of the National Sample Survey Organisation provides an opportunity to examine the impoverishing effect of healthcare spending in India. This paper presents an analysis of the nsso survey data with some new approaches to correcting some of the biases in previous assessments of the "impoverishing" effect of health spending. Despite these corrections, the results suggest that the extent of impoverishment due to healthcare payments is higher than previously reported. Furthermore, outpatient care is more impoverishing than inpatient care in urban and rural areas alike. The analysis of the extent of impoverishment across states, regions (urban and rural areas), income quintile groups, and between outpatient care and inpatient care yields some interesting results.

Socio-economic Performance of Constituencies: A Response

socio-economic Performance of constituencies: A Response Laveesh Bhandari related to poverty levels in Murshidabad as published by Mint and the Congress Party. That was, to clarify, not based on any Indicus estimate, and as such I am unable to respond to that debate.

Income Differentials and Returns to Education

This paper studies the determinants of personal income, including the returns to education. In the process it estimates how incomes are affected by characteristics such as gender, caste, language, etc. Using a maximum likelihood probability model, private returns to education are estimated; it emerges that greater levels of education increase both the likelihood of being employed as well as the income earned from work. However, the returns from elementary (primary and middle) education are quite low. Also, ceteris paribus, women, lower social groups, rural residents, non-English speakers have both significantly lower incomes and a lower likelihood of being employed. The results indicate that quality of education delivery and ensuring that the child remains in school should form important elements of education policy.

Regional Inequality in India

We discuss the relationship of our initial paper [Singh, Bhandari, Chen and Khare 2003] to the work of Deaton and Dreze (2002).

Regional Inequality in India

There are concerns that regional inequality in India has increased after the economic reforms of 1991. This concern is supported by various statistical analyses. This paper shows that the conclusions are sensitive to what measures of attainment are used. In particular, human development indices do not show the same increase in regional inequality. Furthermore, looking at consumption and credit indicators for regions disaggregated below the state level also suggests that inequality trends may not be as bad as suggested by State Domestic Product data, although the greater strength of the economies of the western and southern states emerges in the results. Finally, policy implications within the context of India's evolving federal polity are briefly discussed.

Ensuring Access to Water in Urban Households

This paper deals with how urban Indian households obtain water for their daily requirements. The link between economic status and access allows the analysis of issues such as water sharing, sole access, ability to pay, need for improvements, etc. The authors also put forth a strategy for levying user charges for different economic status households. The data reveal that poor access is accompanied with low levels of expectations of the populace. The paper stresses the need for a substantial consumer awareness campaign before embarking on any improvement programme.
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