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

Articles by Jay Dev DubeySubscribe to Jay Dev Dubey

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.

Estimating Public Spending on Health

The use of information on withdrawals by Drawing and Disbursing Officers for improving the estimates of public spending for National Health Accounts in India is illustrated. Using information from Karnataka and Rajasthan, the study highlights the advantages of combining DDO-level information with budgetary data. The significant benefits of using DDO-level information in India have implications for better estimates of public spending and health policy design.

Fourteenth Finance Commission

Preliminary evidence on the impact of the recommendations of the Fourteenth Finance Commission suggests that there has been an increase in central transfers and social sector expenditures in a number of states in 2015–16. This evidence is biased upwards due to two factors. First, much of the gains have been measured with respect to a low base year. Second, the inferences are affected by systematic differences between actuals, revised estimates, and budget estimates. Using a modified base and comparable estimates for 15 major states, it is seen that these are much smaller. Besides, in most states, social services have received a lower priority over economic services in 2015–16.
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