Syndicate content

Add new comment

Submitted by Nachiket Mor on
Dear Professor Wagstaff, This is an excellent blog post. I would add delayed health-seeking and excessive use of hospitals as contributory factors as well. However, at least in India, despite the fact that they are high relative to per capita income, the principal reason why hospitalisation costs remain low relative to global standards is that they are financed principally on an out-of-pocket basis and a hospital therefore cannot charge more than $40 for example for a CT Scan. I worry that introduction of hospital based insurance schemes, while useful for the insured, will gradually make it harder and harder for the uninsured to get the benefit of these lower costs as the hospitals seek to pass on the difference to the uninsured. And, it will also, perhaps irreversibly so, exacerbate the factors relating to delayed health-seeking behaviours and excessive use of hospitals because one of the effects of the introduction of insurance schemes is that the supply of secondary and tertiary hospitals is like to increase as private capital moves in to benefit from the insurance linked revenues. And, while it is true that the entire country cannot yet afford Universal Healthcare, States like Tamil Nadu and Kerala appear to have the financial resources to do so but are yet not moving in that direction and are instead using scarce resources in more and more generous conditional cash-transfer schemes and hospital insurance programmes. I would be eager to hear your comments on these concerns of mine. Sincerely, Nachiket Mor