One of India’s fundamental failings as a modern nation has been our inability to get successive governments to prioritize and deal with public goods. Public goods (as against private goods) have non-rival and non-excludable consumption which makes pricing difficult. This in turn makes their provision through the market mechanism tricky and hence they have to be provided by the government.
In their latest paper, Shamika Ravi and Rahul Ahluwalia argue that India’s health policy needs to focus more on delivering those aspects of healthcare which are public or quasi-public goods, and on regulating and thus facilitating market provision of those aspects that provide private benefits.
- India’s public health funding must focus on ‘public goods’ in health – primary and preventive care, vaccination and sanitation among others
- Improved governance and management is absolutely critical for actual delivery of health services – the Tamil Nadu Medical Services Corporation governance model could be adopted at larger scale for managing all health services delivered by the states
- Human resource shortages should be plugged by paramedics – graduates of a 3 year course have been shown to be as good as MBBS doctors for common rural primary health problems
- Higher levels of care should be left to the market, while government should focus on providing balanced and transparent regulation to enable the market to function
- Health care financing pitfalls can be avoided by adopting Health Savings Accounts which allow tax exempt savings that can only be used for medical purposes
Here’s a link to the review of this paper which was published in The Wall Street Journal on December 11, 2015. Like other products of the Brookings Institution India Center, this is intended to contribute to discussion and stimulate debate on important issues. The views are those of the author.