Hivos International

The Business of Health Care and the Challenge of Health Security

The main objective of this study is to analyse the functioning of the Rajiv Aarogyasri in Andhra Pradesh, a social health insurance scheme for the poor households, introduced in 2007. Until mid-eighties the state policy in India was free health care provision by the public health care institutions to any citizen seeking it. The private sector also catered to those who were prepared to pay for it. Over the years, there has been very low priority accorded to public health services. Paradoxically, even as there have been great strides in the methods of treatment and improved availability of medicines at relatively lower prices, there has been deterioration in public health facilities. Health care in the country failed to achieve equity in access and service provision. The condition worsened in the 1980s and the liberalisation of the economy in the 1990s aggravated it further. The poor people were the worst sufferers and this necessitated a search for alternative models for providing health care through reforms in health sector. Health insurance through public-private partnership has emerged as one of the important alternative approaches under the neoliberal economic reforms that began in the early nineteens.

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