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Broad Conclusions and Policy Directions

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Paying Out-of-Pocket for Drugs, Diagnostics and Medical Services

Part of the book series: India Studies in Business and Economics ((ISBE))

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Abstract

Drawing upon a set of comprehensive field-based data and an in-depth analysis of the OOP health payments by a cross-section of households from selected rural and urban areas of three different states—UP, Rajasthan and Delhi—there appear to be major challenges ahead for both the planners and administrators of health-care services. This can easily be noticed from the discussion so far. While this chapter however does not intend to replicate most of that discussion or its underlying messages in a conventional setting, it does attempt to cull out briefly a few of the major observations after piecing them together from different chapters as reference points. As regards directions of policy, this chapter sets out to provide scores of considered opinion given by the respondents on issues of critical concerns, e.g. recent increase in health-care charges, overprescription of medicines and/or diagnostics by medical professionals and role of drugs in making health care expensive. This will be followed by another set of respondents’ reactions covering issues in a policy framework such as health insurance and the extent respondents would be willing to go for such a product on a payment basis. Most of these questions and their responses are expected to help in deriving a host of policy recommendations based on considered judgments of those who really matter. It may nevertheless be noted that in no way these recommendations may be treated as out of the box.

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Notes

  1. 1.

    A summary of the major findings is already presented at the beginning of this study.

  2. 2.

    See Sect. 5.3.

  3. 3.

    TRIPS agreement was drawn in January 1995 with a view to bring global minimum standards for the protection of intellectual property, including a minimum 20 years’ patent protection on pharmaceuticals. The compliance of the agreement was however deferred until 2005 for the developing countries and 2016 for least developed countries (Smith et al. 2009a).

  4. 4.

    The government is currently in the process to launch three important insurance covers to fulfil some of its social security obligations: (i) the Aam Aadmi Bima Yojana to provide death and disability cover to the poor, (ii) the Janashree Bima Yojana with an objective to cover health and life risks and finally (iii) the Rashtriya Swasthya Bima Yojana (RSBY) in order to cover the medical risks. An interesting feature of the RSBY is that it proposes to remain without any exclusion clause. With an annual premium of Rs. 600, paid by the centre and states jointly on 75:25 basis, the below-poverty policyholders and their family will be authorised to avail hospitalisation benefits worth Rs. 30,000 a year.

References

  • Smith, R. D., Correa, C., & Oh, C. (2009a). Trade trips and pharmaceuticals. The Lancet, 373(9664), 684–691.

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  • Smith, R. D., Lee, K., & Drager, N. (2009b). Trade and health: An agenda for action. The Lancet, 373(9665), 768–773. doi:10.1016/S0140-6736(08)61780-8. Published online 22 January 2009.

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  • Stiglitz, J. E. (2009, January 31). Trade agreements and health in developing countries (Comment). The Lancet, 373(9661), 363–365.

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Alam, M. (2013). Broad Conclusions and Policy Directions. In: Paying Out-of-Pocket for Drugs, Diagnostics and Medical Services. India Studies in Business and Economics. Springer, New Delhi. https://doi.org/10.1007/978-81-322-1281-2_8

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