Healthcare in India

This paper attempts to explain three broad trends that underpinned the relationship between the state, market, and healthcare: first, the state is moving away from its health provider role to a regulator role, which involves shifting the resources, authority, and responsibility to diverse public and private actors. Second, in the name of the pandemic, the state has opened up fresh frontiers of privatisation and corporatisation of healthcare, extending to non-metropolitan cities and small towns. Third, the above two processes would lead to further exclusion of lower castes, classes, and genders from access to healthcare, spiralling health inequalities.

The role of two policy pillars in achieving immunisation coverage of essential vaccines in India is examined by assessing the funds disbursed by the centre to the state governments under the Universal Immunisation Programme and the available physical health infrastructure in the states. It is found that funds by themselves are ineffective in improving vaccination coverage but are effective in conjunction with the available infrastructure. This finding has important implications for achieving full immunisation coverage, which stems from the sharing of responsibilities between the central and state governments under India’s federalised system of government.

Financing health expenditure through health insurance is currently gaining significance as a strong social policy in countries like India where public health facilities are still inadequate. An attempt to estimate the coverage of health insurance in India shows that the coverage is low and not uniform across states and union territories, despite the fact that several public-funded schemes focus on the below poverty line population. Of the various types of health insurance schemes, public-funded health insurance schemes have a dominant position. Moreover, the likelihood of health insurance coverage is relatively higher among specific social groups and in certain areas.

High natural background radiation is a constant presence in the lives of those inhabiting some coastal regions of Kerala and Tamil Nadu. While there is agreement about the existence of radiation, some studies claim that it has no impact on the health of the population, while others disagree. There is a need to examine these findings critically, because of implications for public health, and to understand some of the technical reasons for why some papers appear to find no support for evidence (lack of statistical significance) of impact on health due to high levels of background radiation.

.