Unifying India’s Healthcare Markets

Murali Neelakantan, A. Kulkarni
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Abstract

This paper delves into the structure of the healthcare market in India, contending the existence of three distinct markets: the government monopsony market, the institutional market, and the retail market. Each of these markets has unique characteristics in terms of healthcare service provisioning, pricing, and accessibility. We underscore systemic failures resulting from a lack of clarity about the structure of these markets, including disparities in service provision, lack of awareness about available services, and skewed incentives favouring private sector provisioning. We suggest unification of India's disparate healthcare markets, advocating for a more prominent role for the government. The proposed unification is a modification of the school voucher program, aimed at ensuring competitiveness on the supply side, and thereby improving service quality. While acknowledging the challenges of scale and state capacity, we argue that the proposal is worthy of further discussion and research, given its potential to harness the government's purchasing power to improve accessibility, affordability, and promote a competitive landscape that encourages innovation and quality in healthcare services.
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统一印度医疗保健市场
本文深入研究了印度医疗保健市场的结构,论述了三个不同市场的存在:政府垄断市场、机构市场和零售市场。这些市场在医疗保健服务供应、定价和可访问性方面都具有独特的特点。我们强调,这些市场的结构缺乏明确性导致了系统性失灵,包括服务提供方面的差异、对现有服务缺乏认识以及偏向私营部门提供的扭曲激励。我们建议统一印度不同的医疗保健市场,倡导政府发挥更重要的作用。这是对教育券制度的修改,目的是确保供给方面的竞争力,从而提高服务质量。在承认规模和国家能力的挑战的同时,我们认为该提案值得进一步讨论和研究,因为它有可能利用政府的购买力来改善可及性、可负担性,并促进竞争格局,鼓励医疗保健服务的创新和质量。
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