Abstract
The book will prove to be an asset for all the health care providers, researchers and students having an inclination towards health economics. The book provides a solid magnitude on fundamental health issues in India and the necessity to understand health economics in the context of current health scenario. Since the Alma Ata Declaration on primary health care in 1978, the redistribution with growth became an important development strategy in India. Policies and programmes related to health resulted in several positive achievements in India, like significant fall in infant mortality rate (IMR), containment of malaria to a great extent, near elimination of leprosy and polio and so on. But on other hand, the book also evidences that there is so much lacking in health care planning and service delivery system as, in India, the importance of investing in health for accelerating economic development has not been adequately appreciated.
The book seems to be an eye opener as it establishes an empirical relationship between health and economic development. In the introductory part, the author demonstrates that health is not merely a component of well-being but also an integral part of national income and development. As an important part of human capital, health contributes towards productivity and in gross national product. Facilitating the marginal utility analysis, the author illustrates a total utility curve for health (see Figure 1: xvi) by describing the law of diminishing marginal utility in health.
Furthermore, establishing the fact of utility curve for health in Chapter 1, the author adds that health is an important parameter for assessing Human Development Index (HDI) or Human Poverty Index (HPI). The author also cites the fact that development in health scenario hoists the gross domestic product (GDP) of a particular country. Also, it was said that poor health intricate poverty as it hinders productivity.
In the second chapter, the author shows how the current scenario of disease burden in India creates severely high morbidity and mortality rate resulting towards waste of cognitive and physical potential of human resources and severe economic loss. The author also cites various comparative data among national, intra-national and international disease burden. It is also shown that India, with 20 per cent of the world’s child population, has the highest number of malnourished children as it contributes to 40 per cent of the world’s malnourished children (pp. 26–27). How social disparities related to gender and caste affect the IMR and maternal mortality rate (MMR) severely has also been shown in this chapter. The third chapter of this book deals with the chronological scenario of health care programmes and policies and their achievements since the independence.
The fourth chapter grapples with the issues of inter-regional and inter-state disparities in health care facilities with regard to the equity aspect. The author explains the correlation between equitable provisioning of health care infrastructure and equity in health service delivery system. Especially, the rural–urban disparity in health service delivery system and its adverse affect on rural economy has been measured in this chapter. The chapter also establishes the fact that disproportionate provisioning of health care results in increase in IMR and MMR, and worsening state of reproductive health among women. Therefore, the author suggests promoting a ‘win-win’ model of public–private partnership in health care management to ameliorate these issues.
In the last chapter, the author demonstrates the meagre emergence of health insurance or health financing in India in the context of various public and private health insurance schemes, that is, Rashtriya Swasthya Bima Yojana (RSBY), Employees State Insurance Scheme (ESIS), etc. Furthermore, the author states that less than 10 per cent of the total population has been covered by some form of insurance (see Table 5.19), which is very sparse compared to the global expenditure on health. The author has even argued that the government expenditure on health is very low by international standards.
The author has empirically described the inherently regressive out-of-pocket expenditure on health which results in disproportionate burden of health care expenditure on the poor. Finally, in the conclusion, the author has suggested several remedial measures which can be adopted by the government, private sectors and Insurance Regulatory Development Authority to address these issues and pave the way towards strengthening the human capital.