Publication: Government Health Insurance for People Below Poverty Line in India: Quasi-Experimental Evaluation of Insurance and Health Outcomes
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2014-09-11
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2019-12-24
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The objective of this study is to evaluate the effects of a government insurance program covering tertiary care for people below the poverty line in Karnataka, India, on out-of-pocket expenditures, hospital use, and mortality.
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Annex one presents an overview of the health system and health financing in India, and annex two discusses the evolutionary context of India's Government sponsored health insurance schemes. The discussion of the mechanics and operational features of these programs has been undertaken to unravel the underlying complexities, interactions, and interdependencies within these programs. The case study also aims to contribute to the ongoing debate within the Indian health sector, with opinions divided between investments in traditional input-based health spending for publicly managed health facilities versus demand-side financing, purchasing of care, and involving private providers and intermediaries in delivering services financed by public money. The case study also aims to share how the lessons learned by one program can be applicable more widely within the Indian health system and beyondPublication Government-Sponsored Health Insurance in India : Are You Covered?(2012-08-26)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. 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In addition, the chapter reviews the variety of entities that sell private health insurance.Publication Social Health Insurance vs. Tax-Financed Health Systems—Evidence from the OECD(2009-01-01)This paper exploits the transitions between tax-financed health care and social health insurance in the OECD countries over the period 1960-2006 to assess the effects of adopting social health insurance over tax finance on per capita health spending, amenable mortality, and labor market outcomes. The paper uses regression-based generalizations of difference-in-differences and instrumental variables to address the possible endogeneity of a country's health system. It finds that adopting social health insurance in preference to tax financing increases per capita health spending by 3-4 percent, reduces the formal sector share of employment by 8-10 percent, and reduces total employment by as much as 6 percent. For the most part, social health insurance adoption has no significant impact on amenable mortality, but for one cause-breast cancer among women-social health insurance systems perform significantly worse, with 5-6 percent more potential years of life lost.Publication Bhutan : Maternal and Reproductive Health at a Glance(World Bank, Washington, DC, 2014-11)Bhutan is a small landlocked country in the Himalayas between China and India. Poverty reduction has been rapid from about 23 percent in 2007 to 12-13 percent in 2012. Gender equality and women's empowerment are important determinants of reproductive health. Contraceptive prevalence rate (CPR) is higher among the poorest quintile than the richest. Large disparities in access to skilled birth attendant remain by geography and wealth quintile. Poor nutrition is a serious issue for pregnant mothers, since 55 percent of women are anemic. Bhutan will need to focus on increasing the focus on quality along the continuum of care; improving access and equity; and ensuring sustainability of health financing.
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