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

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Hospital Network and Healthcare Access

The strategies for eliminating financial barriers to medical care work well in an equitably distributed healthcare system. The paper suggests that where healthcare facilities are equally distributed, the benefits of insurance are better utilised. But, more importantly, a good public health system in itself is sufficient to promote equitable access to healthcare. Further, insurance does little to encourage and redirect private healthcare providers to cover the critical gap in the health facilities. The private hospital care providers are located more in areas where (public and/or private) facilities are already concentrated.

Status of Women’s Health Insurance in India

Despite the Ayushman Bharat scheme, the poorest and poor women of other social groups are minimally covered with health insurance compared to the rest of the social groups. In this regard, the article explores the regional disparities and socio-economic inequalities in accessing insurance schemes for women in India, particularly the policies and programmes (and assesses the achievement of SDG 3) so that they can be accessed by those women who are below and marginally above the poverty line.

 

Nature of Health Insurance Demand in India

In this paper, an attempt is made to explore the elasticity of health insurance demand in India. Keeping in view the central and state government efforts as well as rural–urban disparities in the country, we evaluate whether people have appropriate information about these governmental schemes and the influence of other socio-economic factors on individual household choices.

Will the Insurance Model Save Indian Healthcare?

In this episode, we speak to Sylvia Karpagam and Shailender Kumar Hooda about Ayushman Bharat and the health insurance model in India.

Experiences with Government-sponsored Health Insurance Schemes in Indian States

The implications of expanding government-sponsored health insurance schemes in India are analysed from a fiscal perspective. The experiences of two of the earliest and largest GSHI schemes of the country implemented in Andhra Pradesh and Tamil Nadu are examined. The results suggest that the expansion of the GSHI schemes may skew expenditure away from primary and secondary care towards tertiary care if the fiscal space is limited. A competitive public health system may help in containing costs and the corresponding fiscal burden. The effectiveness of public spending through such schemes is ambiguous.

 

COVID-19, Health Insurance and Access to Healthcare

Addressing the COVID-19 pandemic with a robust healthcare system, and effective government intervention with appropriate regulation on private sector, is a more appropriate option than resorting to insurance to cover COVID-19 related care, or healthcare in general.

 

Evaluating Health Insurance Programmes

An array of bottlenecks has ensured that the numerous health insurance schemes introduced over the years have failed to make any significant dent on the health sector. This article tries to assess these problems by using the “insurance cascade,” a framework that traces the steps from enrolling eligible households to ultimately delivering their benefits. The existing evidence suggests substantial bottlenecks across all cascade steps, with especially large gaps in beneficiaries’ awareness of how to enrol in schemes, what the schemes covers, and how to access scheme benefits.

From RSBY to PMJAY

Healthcare for India’s Poor: The Health Insurance Way by Sonalini Khetrapal, New Delhi, Gurugram: Academic Foundation, 2019; pp 192, `1,195.

 

Risky Insurance: The Pradhan Mantri Jan Arogya Yojana in Jharkhand

A ground-level survey of the Pradhan Mantri Jan Arogya Yojana in Jharkhand reveals that the scheme nudges patients towards the private sector under the guise of free healthcare only for them to incur exorbitant expenditure over the course of treatment.

Estimates of Health Insurance Coverage in India

Financing health expenditure through health insurance is currently gaining significance as a strong social policy in countries like India where public health facilities are still inadequate. An attempt to estimate the coverage of health insurance in India shows that the coverage is low and not uniform across states and union territories, despite the fact that several public-funded schemes focus on the below poverty line population. Of the various types of health insurance schemes, public-funded health insurance schemes have a dominant position. Moreover, the likelihood of health insurance coverage is relatively higher among specific social groups and in certain areas.

Ayushman Bharat and the False Promise of Universal Healthcare

What implications will a health insurance scheme that relies on private capital have for India’s healthcare system?

Flaws of Insurance-based Healthcare Provision

Tamil Nadu is recognised for its achievements in human development, especially in the area of healthcare. In light of the central government’s recent move to launch insurance-based targeted healthcare provision, a case is made for paying attention to building public health infrastructure based on Tamil Nadu’s experience with healthcare provisioning. The pitfalls of insurance-based provisioning and targeting, and the need to recognise regional trajectories and institutional innovations in this regard are highlighted.

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