Publication: Government-Sponsored Health Insurance in India : Are You Covered?
Date
2012-08-26
ISSN
Published
2012-08-26
Author(s)
Abstract
Since independence, India has struggled
to provide its people with universal health coverage.
Whether defined in terms of financial protection or access
to and effective use of health care, the majority of Indians
remain irregularly and incompletely covered. Finally, and
most recently, a new generation of Government-Sponsored
Health Insurance Schemes (GSHISs) has emerged to provide the
poor with financial coverage. Briefly, the main objective of
these new GSHISs was to offer financial protection against
catastrophic health shocks, defined in terms of an inpatient
stay. Between 2007 and 2010, six major schemes have emerged,
including one sponsored by the Government of India (GOI) and
five state-sponsored schemes. This new wave of schemes
provides fully subsidized coverage for a limited package of
secondary or tertiary inpatient care, targeting below
poverty populations. Similar to the private voluntary
insurance products in the country, ambulatory services
including drugs are not covered except as part of an episode
of illness requiring an inpatient stay. The schemes have
organized hospital networks consisting of public and private
facilities, and most care funded by these schemes is
provided in private hospitals. Ostensibly, the objective of
any health insurance scheme is to increase access,
utilization, and financial protection, and ultimately
improve health status. Due to lack of evaluations and
analyses of household data, the authors of this book do not
examine the impact of health insurance in terms of these
objectives. This book is not meant to highlight problems of
the GSHISs, but rather to raise potential challenges and
emerging issues that should be addressed to ensure the
long-term viability of these schemes and secure their place
within the health finance and delivery system.
Link to Data Set
Citation
“La Forgia, Gerard; Nagpal, Somil. 2012. Government-Sponsored Health Insurance in India : Are You Covered?. Directions in development : human development;. © http://hdl.handle.net/10986/11957 License: CC BY 3.0 IGO.”
Report Series
Report Series
Other publications in this report series
-
PublicationGetting to Work: Unlocking Women's Potential in Sri Lanka's Labor Force(Washington, DC: World Bank, 2020-03-02)Sri Lanka has shown remarkable persistence in low female labor force participation rates—at 36 percent in the past two years, compared with 75 percent for same-aged men—despite overall economic growth and poverty reduction over the past decade. The trend stands in contrast to the country’s achievements in human capital development that favor women, such as high levels of female education and low total fertility rates, as well as its status as a lower-middle-income country. This study intends to better understand the puzzle of women’s poor labor market outcomes in Sri Lanka. Using nationally representative secondary survey data—as well as primary qualitative and quantitative research—it tests three hypotheses that would explain gender gaps in labor market outcomes: (1) household roles and responsibilities, which fall disproportionately on women, and the associated sociophysical constraints on women’s mobility; (2) a human capital mismatch, whereby women are not acquiring the proper skills demanded by job markets; and (3) gender discrimination in job search, hiring, and promotion processes. Further, the analysis provides a comparison of women’s experience of the labor market between the years leading up to the end of Sri Lanka’s civil war (2006–09) and the years following the civil war (2010–15). The study recommends priority areas for addressing the multiple supply- and demand-side factors to improve women’s labor force participation rates and reduce other gender gaps in labor market outcomes. It also offers specific recommendations for improving women’s participation in the five private sector industries covered by the primary research: commercial agriculture, garments, tourism, information and communications technology, and tea estate work. The findings are intended to influence policy makers, educators, and employment program practitioners with a stake in helping Sri Lanka achieve its vision of inclusive and sustainable job creation and economic growth. The study also aims to contribute to the work of research institutions and civil society in identifying the most effective means of engaging more women—and their untapped potential for labor, innovation, and productivity—in Sri Lanka’s future.
-
PublicationPaths between Peace and Public Service: A Comparative Analysis of Public Service Reform Trajectories in Postconflict Countries(Washington, DC: World Bank, 2019)Building a capable public service is fundamental to postconflict state building. Yet in postconflict settings, short-term pressures often conflict with this longer-term objective. To ensure peace and stabilize fragile coalitions, the imperative for political elites to hand out public jobs and better pay to constituents dominates merit. Donor-financed projects that rely on technical assistants and parallel structures, rather than on government systems, are often the primary vehicle for meeting pressing service delivery needs. What, then, is a workable approach to rebuilding public services postconflict? Paths between Peace and Public Service seeks to answer this question by comparing public service reform trajectories in five countries—Afghanistan, Liberia, Sierra Leone, South Sudan, and Timor-Leste—in the aftermath of conflict. The study seeks to explain these countries’ different trajectories through process tracing and structured, focused methods of comparative analysis. To reconstruct reform trajectories, the report draws on more than 200 interviews conducted with government officials and other stakeholders, as well as administrative data. The study analyzes how reform trajectories are influenced by elite bargains and highlights their path dependency, shaped by preconflict legacies and the specifics of the conflict period. As the first systematic study on postconflict public service reforms, it identifies lessons for the future engagement of development partners in building public services.
-
PublicationOptions for Aged Care in China: Building An Efficient and Sustainable Aged Care System(Washington, DC: World Bank, 2018-11-20)China is aging at an unprecedented rate. Improvements in life expectancy and the consequences of the decades-old family planning policy have led to a rapid increase in the elderly population. According to the United Nations World Population Prospects, the proportion of older people age 65 and over will increase by about one-fourth by 2030, and the elderly will account for about one quarter of the total population by 2050. Population aging will not only pose challenges for elder care but also have an impact on the economy and all aspects of society (World Bank, 2016a). The government is aware of the need to develop an efficient and sustainable approach to aged care. To this end, the General Office of the State Council issued the 12th Five-Year Plan for the Development of Aged Care Services in China and the Development Plan for a System of Social Services for the Aged (2011-2015). It is now in the process of formulating the 13th Five-Year National Plan on Aging, which will further elaborate and finalize the reform roadmap for 2016 to 2020. The Plan is expected to be finalized and launched by June 2016. The National Development and Reform Commission (NDRC) helped draft these plans and is now leading the development of policy measures for the provision of social services for the elderly. This volume has been prepared to support the translation of the broad ideas on aged care provision expressed in the 12th and 13th Five-Year Plans and other government plans into reality and to help the government tackle the challenges described above. It strives to identify a policy framework that fits the Chinese context and can be put in place gradually. Specifically, it aims to provide an up-to-date understanding of the evolving aged care landscape in China; review international experiences in long-term care provision, financing, and quality assurance and assess their relevance to China’s current situation; discuss implications of current developments and trends for the future of aged care in China; and propose policy options based on available evidence and best practices.
-
PublicationToward Great Dhaka: A New Urban Development Paradigm Eastward(Washington, DC: World Bank, 2018-07-03)A unique strategic opportunity beckons Bangladesh. Dhaka, the economic powerhouse of the country, stands on the cusp of a dramatic transformation that could make it much more prosperous and livable. Today, Dhaka is prone to flooding, congestion, and messiness, to a point that is clogging its growth. But toward its east, where two major highway corridors will one day intersect, is a vast expanse of largely rural land. And much of it is within 6 kilometers of the most valuable parts of the city. The time to make the most of this eastward opportunity is now. Many parts of East Dhaka are already being developed in a haphazard way at an alarmingly rapid pace. Private developers are buying land and filling it with sand so they can build and sell new houses and apartments. Canals and ponds are disappearing, and the few narrow roads crossing the area are being encroached by construction. This spontaneous development could soon make East Dhaka look like the messy western part of the city, and retrofitting it later will be more difficult and costlier than properly planning and developing it now. Toward Great Dhaka: A New Urban Development Paradigm Eastward seeks to analyze how the opportunity of East Dhaka could be realized. Using state-of-the-art modeling techniques, the study simulates population, housing, economic activity, and commuting times across the 266 unions that constitute Greater Dhaka. It does so under various scenarios for the development of East Dhaka, but always assessing the implications for the entire city. The simulations suggest that pursuing a strategic approach to the development of East Dhaka would make Greater Dhaka a much more productive and livable city than continuing with business as usual. Based on current trends, Greater Dhaka would have a population of 25 million in 2035 and an income per capita of US$8,000 at 2015 prices. However, embracing a strategic approach would add 5 million people to the city. And, it would be a more productive city, with nearly 1.8 million more jobs and an income per capita of more than US$9,200 at 2015 prices, enough to put Dhaka on the map of global cities.
-
PublicationReforming Non-Tariff Measures: From Evidence to Policy Advice(Washington, DC: World Bank, 2018-06-13)High levels of trade costs persist in the world trading system, despite recent progress in tariff reduction, trade facilitation, and logistics. At least some of these costs can be attributed to non-tariff measures (NTMs), policies imposed by governments other than ordinary customs duties which have an impact on the price at which exports and imports are traded, the quantities traded, or both. Such costs are particularly worrisome if they have a discriminatory or protectionist effect, or violate countries’ international commitments. However, even NTMs designed to carry out domestic regulatory objectives – for example, protection of human, animal or plant health, consumer or workplace safety, or the environment – can have substantial effects on international trade, which should be considered when such policies are developed. This book discusses some of the analytical methods that can be used to accompany the process of policy development for NTMs. It discusses the broad economic rationale for improving the design of NTMs;, illustrates the main forms of quantification of NTMs and their effects, including inventory approaches, price-based approaches, and quantity-based approaches; proposes a new analytical and measurable concept of “regulatory distance” to help guide deep integration efforts at the regional level; provides a discussion of the effects of NTMs on household expenditures, poverty, and firm competitiveness; and shows how empirical analysis of NTMs can be used to inform policy advice. As such, it should provide a valuable addition to the arsenal of tools available for applied analysis of international trade policy.