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Fiscal Marksmanship in Health Expenditure

Vol. 57, Issue No. 43, 22 Oct, 2022
Vishalkumar J Jani

There is a dearth of literature about fi scal marksmanship beyond total revenue expenditures and defi cits at the central or state level. It is of utmost importance to elicit a debate on the budgetary discipline around micro variables. These micro-level deviations result in macro-level errors in budget forecasting. The article explores state-level fi scal marksmanship in the context of medical and public health expenditure over the period—2002 to 2017. The deviations in capital health spending are high compared to those in revenue health spending. This may have an impact on the improvement in health over the long term.

State and Health Markets in the Time of Pandemic

Vol. 57, Issue No. 23, 04 Jun, 2022
Purendra Prasad

This paper attempts to explain three broad trends that underpinned the relationship between the state, market, and healthcare: first, the state is moving away from its health provider role to a regulator role, which involves shifting the resources, authority, and responsibility to diverse public and private actors. Second, in the name of the pandemic, the state has opened up fresh frontiers of privatisation and corporatisation of healthcare, extending to non-metropolitan cities and small towns. Third, the above two processes would lead to further exclusion of lower castes, classes, and genders from access to healthcare, spiralling health inequalities.

The Making of ‘Local Health Traditions’ in India

Vol. 53, Issue No. 30, 28 Jul, 2018
Arima Mishra, DEVAKI NAMBIAR, Harilal Madhavan

The Indian government’s attention to the mainstreaming of traditional systems of medicine and the revitalisation of community-based local health traditions needs to be viewed as a part of its overall mandate of strengthening traditional systems of medicine. An analysis of existing policy documents and reviews reveals that LHTs have an eclectic policy history in India, marked by several decades of neglect by the state, with sporadic attention to the LHT practitioners as community health workers, to an upsurge of seemingly explicit, and yet somehow obtuse interest in revitalisation. Tracing the evolution (and dissolution) of these trajectories chronologically reveals that there is ambiguity and inconsistency around the rationales for the revitalisation of LHTs, potentially leading to fragmented medical pluralism.

Is NITI Aayog Even Thinking about Health?

Vol. 51, Issue No. 20, 14 May, 2016
Ravi Duggal

The NITI Aayog has effectively stalled the finalisation and tabling of the National Health Policy 2015 in Parliament. The document, including the Parliamentary Standing Committee on Health and Family Welfare's report, should be revived to put forth a concrete plan for transforming the healthcare system in India.

Need for Protocols in Public Health

Vol. 50, Issue No. 12, 21 Mar, 2015
Meeta Rajivlochan

The deaths in Chhattisgarh during a state-sponsored family planning camp held in November 2014 show, yet again, that the lack of checklists and an ad hoc style of functioning can and does result in disaster. This article explains the need for standardisation and protocols in key government processes and talks about the pathetic conditions in which medicines and surgical supplies are procured in public hospitals as well as the failure of state agencies to detect and prohibit sale of substandard drugs.

Healthcare

Vol. 50, Issue No. 10, 07 Mar, 2015
Chaitanya Agarwal

This letter is in response to the article by Meeta Rajivlochan, “Improving Healthcare Services at Reduced Prices” (EPW, 3 January 2015). I am not sure if laying down standards of healthcare is practical and implementable and whether any example of the same exists in other countries.

Burden of Out-of-Pocket Health Payments in Andhra Pradesh

Vol. 49, Issue No. 42, 18 Oct, 2014
Srikant Nagulapalli

After the introduction of the large-scale Rajiv Aarogyasri Scheme in undivided Andhra Pradesh during 2007, which was meant to protect poor families from catastrophic inpatient health expenses, no reliable data is available to assess out-of-pocket health payments in the state. The latest data available is from the last round of a health survey by the National Sample Survey Office in 2004-05. This study estimates the OOP health expenditure in Andhra Pradesh in 2012-13, and provides estimates for the year's from 2004-05 onwards. The paper points out that the need is to formulate a state health policy, which, among other things, targets a government health expenditure to total health expenditure ratio of 0.8.

Political Accountability for Outbreaks of Communicable Diseases

Vol. 49, Issue No. 13, 29 Mar, 2014
Debabar Banerji

The political and bureaucratic "leadership" of India's public health services and programmes, unqualified and untrained for this role, has allowed foreign and international agencies to set the country's health agenda. In the process, while massive amounts are being pumped into health programmes, the health services have deteriorated and the poor continue to suffer.

Too Little, Too Late

Vol. 49, Issue No. 2, 11 Jan, 2014
Sujata Gothoskar

While the union government announced its plan to extend the Rashtriya Swasthya Bima Yojana to the unorganised working class poor like rickshaw-pullers, ragpickers, mineworkers, sanitation workers, etc, the Government of Maharashtra has decided to scrap RSBY and replace it with the Rajiv Gandhi Jeevandayee Arogya Yojana. This article analyses the conditions of waste pickers and argues not to pit one type of healthcare against another and not to scrap schemes like the RSBY that have come anyway too late.

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