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

Ramesh BhatSubscribe to Ramesh Bhat

Analysis of Public and Private Healthcare Expenditures

The basic objective of healthcare systems is to meet a country's health needs in the most equitable and efficient manner, while remaining financially sustainable. Each country, given the historical evolution of its healthcare system, adopts different strategies to achieve these goals. The financing of healthcare through public and/or private channels is one important component of this strategy, as it has a significant bearing on the way healthcare is delivered and also has implications for the health policy goals of equity, efficiency and sustainability. Understanding what determines these expenditures is important from the viewpoint of health policy. This paper examines the relationship between income and public and private healthcare expenditures.

Cash and Cash-Equivalent Holdings of Companies

Incentives for holding cash and cash-equivalents vary. The authors suggest that companies that have more block-shareholders have a lesser incentive to hold cash and cash-equivalents. Also, monitoring by debt-holders reduces their incentive to retain excess cash. Besides, after controlling for the group affiliation, size, tangibility of assets, and profitability of the company, aggregate corporate shareholdings were also found to influence the holding of cash.

Financing Issues in Providing Anti-retroviral Drugs for HIV/AIDS Treatment in India

The development of anti-retroviral therapy has given new hope for people living with the acquired immuno deficiency syndrome. The government of India has initiated anti-retroviral treatment as a part of the national public health programme in six high-prevalence states. This paper aims to examine the financial implications of initiating anti-retroviral therapy programme in the country. It highlights the importance of infrastructure and logistic requirements for developing a comprehensive treatment programme for the affected population. Finally, the paper estimates the broad financial implications of the anti-retroviral therapy under different treatment scenarios. The estimated financial requirements for treatment vary from Rs 92 crore per annum if 4,00,000 HIV/AIDS cases are covered to Rs 1,008 crore per annum if all four million patients are screened. Against this, when the programme was started the National Aids Control Organisation had allocated a total of Rs 113 crore for the treatment part of this intervention. Even under the most conservative estimate, achieving the treatment target in India with this budget will be a challenging task.

Healthcare Proposals : Health Insurance

Expanding the insurance services without considering whether medical services are available or not is a sure way of making the scheme dysfunctional from the beginning. Who will regulate the practices of providers? Is the government trying to divert attention from the inefficient healthcare delivery system by using a health insurance 'mantra'?

Health Insurance and Third Party Administrators

The Insurance Regulatory and Development Authority in India has paved the way for insurance intermediaries such as third party administrators (TPAs) to play a pivotal role in setting up managed healthcare systems. TPAs have been set up to ensure better services to policyholders and to mitigate some of the negative consequences of private health insurance. However, given the demand and supply-side complexities of private health insurance and healthcare markets, insurance intermediaries face immense challenges. IRDA has defined the role of TPAs as one of managing claims and reimbursement. Their role in controlling costs of healthcare and ensuring appropriate quality of care is less well-defined.

Issues in Health

Public-private partnerships in the health sector can bring needed resources while also taking care that the vulnerable groups - the poor and rural populations - have access to health facilities. The government must clarify its policy towards the private sector and ensure that public spending on health does not decline. It must also determine a structure of subsidies and incentives for such partnerships.
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