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The rise of government-funded health insurance in India

Author

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  • Patnaik, Ila

    (National Institute of Public Finance and Policy)

  • Roy, Shubho

    (National Institute of Public Finance and Policy)

  • Shah, Ajay

    (National Institute of Public Finance and Policy)

Abstract

India has experienced a remarkable proliferation of 48 Government Funded Health Insurance Schemes (GFHIS) from 1997 to 2018. We place the rise of this policy pathway in historical perspective. Under colonial rule, there was considerable importance placed upon public health as a local public good. After independence, the Bhore Committee build a paradigm of public sector health care, and the public health system degraded. In this environment, the political process faced a high disease burden coupled with a weak public health care system. This pressure led to the adoption of GFHIS as a convenient way forward. We identify four areas of concern in this new paradigm of Indian health policy: inefficient lack of focus upon public health, regulatory problems with private health care, weak regulation of health insurance companies, and fiscal risk.

Suggested Citation

  • Patnaik, Ila & Roy, Shubho & Shah, Ajay, 2018. "The rise of government-funded health insurance in India," Working Papers 18/231, National Institute of Public Finance and Policy.
    • Handle: RePEc:npf:wpaper:18/231
    Note: Working Paper 231, 2018
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    References listed on IDEAS

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    1. Sapatnekar, Sanhita & Patnaik, Ila & Kishore, Kamal, 2018. "Regulating Infrastructure Development in India," Working Papers 18/230, National Institute of Public Finance and Policy.
    2. Choudhury, Mita & Mohanty, Ranjan Kumar, 2018. "Utilisation, Fund Flows and Public Financial Management under the National Health Mission," Working Papers 18/227, National Institute of Public Finance and Policy.
    3. Berman, Peter A., 1998. "Rethinking health care systems: Private health care provision in India," World Development, Elsevier, vol. 26(8), pages 1463-1479, August.
    4. Karan, Anup & Yip, Winnie & Mahal, Ajay, 2017. "Extending health insurance to the poor in India: An impact evaluation of Rashtriya Swasthya Bima Yojana on out of pocket spending for healthcare," Social Science & Medicine, Elsevier, vol. 181(C), pages 83-92.
    5. Desai, Sonalde & Dubey, Amaresh & Joshi, Brij Lal & Sen, Mitali & Sharif, Abusaleh & Vanneman, Reeve, 2010. "Human Development in India: Challenges for a Society in Transition," OUP Catalogue, Oxford University Press, number 9780198065128.
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    1. Shah, Ajay, 2021. "Indian Health Policy in Light of COVID-19: The Puzzle of State Capacity and Institutional Design," India Policy Forum, National Council of Applied Economic Research, vol. 17(1), pages 31-75.
    2. Malhotra, Shefali & Patnaik, Ila & Roy, Shubho & Shah, Ajay, 2018. "Fair play in Indian Health Insurance," Working Papers 18/228, National Institute of Public Finance and Policy.

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