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

Articles by Shailender Kumar HoodaSubscribe to Shailender Kumar Hooda

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.

State of Vaccine Manufacturing in India

Historically, vaccine manufacturing in India has centred around the production of a wide variety of conventional vaccines that made the country self-sufficient as well as a net exporter and global leader in supplying vaccines to low- and middle-income countries. However, over the course of time, other safe and efficacious vaccines that follow technologically more advanced manufacturing processes became available in the market and their increased uptake made the country import dependent. In the second half of the 2000s, when manufacturing capacity of the public sector was being dismantled, India became a big market for imported vaccines and export was affected adversely till recently.

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.

 

Decoding Ayushman Bharat

The challenges before the components of Ayushman Bharat, the (ir)rationality behind raising the insurance coverage manifold are highlighted, a political economy narrative of the changing health financing scenario is drawn, and how the design of Ayushman Bharat will feed into executing the proposed public–private partnership model in public facilities and facilitate the strategic purchasing agenda of the National Health Policy is examined. Ayushman Bharat is a step towards creating a system that would facilitate in relinquishing public funds and public institutions to already dominant private players, which will have serious implications for the healthcare delivery system in India.

Health Payments and Household Well-being

Health policy pronouncements in India currently advocate insurance-based financing mechanisms towards universal health coverage, sidelining the role of comprehensive healthcare provisioning through the public sector. This study, however, suggests that health insurance has been unsuccessful in protecting households from poverty and impoverishment resulting from out-of-pocket payments, and that insurance in fact subverts the effectiveness of the traditional health financing system. Free or low-cost healthcare provisioning by the state remains the best way to enhance the health and well-being of households, provided the inadequacies and inequalities across districts are addressed, and low-cost medicines and diagnostics made available to all.

Health Insurance, Health Access and Financial Risk Protection

Drawing from the 60th and 68th rounds of National Sample Survey Office, this study evaluates the impact of different (social, commercial and target-oriented) health insurance schemes on access to healthcare use, and cost of care and financing of medical expenses. The results show that though these schemes promote access to healthcare, they also increase the costs manifold. The commercial insurers have not been effective at pooling financial risks and seem to be indulging in maximising individual gain. Given the intrinsic market-failure and information asymmetry between the principal and the agents and difficulties in regulating the insurance-base system, this study advocates financing healthcare through a tax-based system which can be cost-effective for achieving universal healthcare access in India.

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