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Health care reforms in India: Getting it wrong
Journal article   Open access   Peer reviewed

Health care reforms in India: Getting it wrong

A.S. Bali and M. Ramesh
Public Policy and Administration, Vol.30(3-4), pp.300-319
2015
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Abstract

India’s first health policy document in 1946 envisaged an ambitious health system comprising delivery of public health programs by the national governments and primary and secondary care by the state governments. Nearly seven decades later, neither of the ambitions have been realised. The delivery of public health programs is limited and uncoordinated, whilst primary and especially secondary care is of poor quality and unaffordable to the bulk of the population. This article assesses India’s health policy reforms and argues that at each juncture the policy instruments it utilised were inconsistent with the goals it was trying to achieve. The health care sector required more intervention than the central and state governments offered. The meagre funds allocated to public health programs and the unwillingness and inability of state governments to shoulder responsibility for primary and secondary care led to the dominance of the private sector in delivery, out-of-pocket financing, and fee-for-service payment to providers. Recent reforms have made some progress in addressing the lacunae but are handicapped by the pervasive dominance of the private sector which severely limits the choice of policy tools available to the government.

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UN Sustainable Development Goals (SDGs)

This output has contributed to the advancement of the following goals:

#3 Good Health and Well-Being
#5 Gender Equality

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1 Clinical & Life Sciences
1.156 Healthcare Policy
1.156.381 Maternal Health Equity
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Public Administration
ESI research areas
Social Sciences, general
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