Past studies have shown that income shocks can trigger women to embark on commercial sex. This paper studies some microeconomic effects of the Cote d’Ivoire’s political instability in 2011 after the presidential election. We use a unique dataset, collected right before and after the crisis, on individuals sampled in health centers, which, coupled with biomarkers on HIV, allows to evaluate the consequences of the conflict. We first use subjective measures of exposure to document the entity of the crisis. We then analyze the consequence of the crisis on income and consumption during and right after the crisis. We show that individuals engage in transactional sex to make up for income loss. In particular, women who are young, unmarried and without a stable source of income increased their number of sexual partners by 26% and received 44% higher amounts of transfers right after the crisis. In the same line, we also find that the incidence of HIV grew to around 1.2% for women and 0.8% for men in conflict-intensive regions.
{"title":"Economic and Health Impacts of the 2011 Post-Electoral Crisis in Côte D’Ivoire: Evidence from Microdata","authors":"Michel Tenikué, Miron Tequame","doi":"10.2139/ssrn.3106750","DOIUrl":"https://doi.org/10.2139/ssrn.3106750","url":null,"abstract":"Past studies have shown that income shocks can trigger women to embark on commercial sex. This paper studies some microeconomic effects of the Cote d’Ivoire’s political instability in 2011 after the presidential election. We use a unique dataset, collected right before and after the crisis, on individuals sampled in health centers, which, coupled with biomarkers on HIV, allows to evaluate the consequences of the conflict. We first use subjective measures of exposure to document the entity of the crisis. We then analyze the consequence of the crisis on income and consumption during and right after the crisis. We show that individuals engage in transactional sex to make up for income loss. In particular, women who are young, unmarried and without a stable source of income increased their number of sexual partners by 26% and received 44% higher amounts of transfers right after the crisis. In the same line, we also find that the incidence of HIV grew to around 1.2% for women and 0.8% for men in conflict-intensive regions.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"96 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129264319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the population ageing the development of sustainable long-term care institutions is of great importance in many European countries. In Poland, currently dominant, traditional and family based care will become insufficient with increasing cohorts of older people. Presented paper discusses recent developments in long-term care policy in the country. Long-term care institutions are separated in the two sectors, with little field for cooperation and coordination of activities. Over the past years policy addressing ageing related problems was developed, focusing on the active ageing instruments. Dependency prevention and active ageing are among goals of national policies formulated separately in the health and social sector. Information policy and monitoring long-term care services’ provision remains insufficient. Coordination of activities mainly takes place at the local level. Local governments and non-governmental organizations, often cooperating with representatives of older people, are active in providing services to older people in community and often incorporating innovative solutions in care.
{"title":"Quality and Cost-Effectiveness in Long-Term Care and Dependency Prevention: The Polish Policy Landscape","authors":"S. Golinowska, A. Sowa","doi":"10.2139/ssrn.3076835","DOIUrl":"https://doi.org/10.2139/ssrn.3076835","url":null,"abstract":"With the population ageing the development of sustainable long-term care institutions is of great importance in many European countries. In Poland, currently dominant, traditional and family based care will become insufficient with increasing cohorts of older people. Presented paper discusses recent developments in long-term care policy in the country. Long-term care institutions are separated in the two sectors, with little field for cooperation and coordination of activities. Over the past years policy addressing ageing related problems was developed, focusing on the active ageing instruments. Dependency prevention and active ageing are among goals of national policies formulated separately in the health and social sector. Information policy and monitoring long-term care services’ provision remains insufficient. Coordination of activities mainly takes place at the local level. Local governments and non-governmental organizations, often cooperating with representatives of older people, are active in providing services to older people in community and often incorporating innovative solutions in care.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132062775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gerry Yemen, S. Snell, J. Meara, C. McClain, Nakul P. Raykar
There are change efforts, and there are change efforts. Edna Adan Ismail, referred to in the Western press as the Muslim Mother Teresa, created a small revolution when she founded the Edna Adan Maternity Hospital in Hargeisa, Somaliland. From securing buy-in and permissions from Siad Barre's government, acquiring land and struggling to keep it, and designing and constructing a new building, to educating a health care workforce, attracting physicians, and attending to the health care needs of a poor population, the case sets the stage for an analysis of change management. As Edna Adan Ismail feels the impact of globalization and the demands of global standards of care from the developed world, she faces some complex problems. How would she continue to add and improve hospital operations, educate the local population of health care providers and patients, and meet the objectives and standards of international actors? The material in this case presents complex problems around efforts to innovate and implement change on a grand scale. Excerpt UVA-OB-1082 Rev. May 4, 2016 Transformation in Somaliland: Edna Adan Maternity Hospital If you cannot do it with your heart, your hands will never do it. —Edna Adan Ismail's father Edna Adan Ismail, referred to in the Western press as the Muslim Mother Teresa, created a small revolution when she founded the Edna Adan Maternity Hospital in Hargeisa, Somaliland. From securing buy-in and permissions from the government to acquire land to attending to the health care needs of a poor population, Edna Adan Ismail faced, influenced, and removed numerous barriers to open and run a hospital in a resource-poor country. . . .
{"title":"Transformation in Somaliland: Edna Adan Maternity Hospital","authors":"Gerry Yemen, S. Snell, J. Meara, C. McClain, Nakul P. Raykar","doi":"10.2139/ssrn.2974847","DOIUrl":"https://doi.org/10.2139/ssrn.2974847","url":null,"abstract":"There are change efforts, and there are change efforts. Edna Adan Ismail, referred to in the Western press as the Muslim Mother Teresa, created a small revolution when she founded the Edna Adan Maternity Hospital in Hargeisa, Somaliland. From securing buy-in and permissions from Siad Barre's government, acquiring land and struggling to keep it, and designing and constructing a new building, to educating a health care workforce, attracting physicians, and attending to the health care needs of a poor population, the case sets the stage for an analysis of change management. As Edna Adan Ismail feels the impact of globalization and the demands of global standards of care from the developed world, she faces some complex problems. How would she continue to add and improve hospital operations, educate the local population of health care providers and patients, and meet the objectives and standards of international actors? The material in this case presents complex problems around efforts to innovate and implement change on a grand scale. Excerpt UVA-OB-1082 Rev. May 4, 2016 Transformation in Somaliland: Edna Adan Maternity Hospital If you cannot do it with your heart, your hands will never do it. —Edna Adan Ismail's father Edna Adan Ismail, referred to in the Western press as the Muslim Mother Teresa, created a small revolution when she founded the Edna Adan Maternity Hospital in Hargeisa, Somaliland. From securing buy-in and permissions from the government to acquire land to attending to the health care needs of a poor population, Edna Adan Ismail faced, influenced, and removed numerous barriers to open and run a hospital in a resource-poor country. . . .","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128429855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time.
{"title":"Introducing Risk Adjustment and Free Health Plan Choice in Employer-Based Health Insurance: Evidence from Germany","authors":"Adam Pilny, A. Wübker, Nicolas R. Ziebarth","doi":"10.2139/ssrn.3051702","DOIUrl":"https://doi.org/10.2139/ssrn.3051702","url":null,"abstract":"To equalize differences in health plan premiums due to differences in risk pools, the German legislature introduced a simple Risk Adjustment Scheme (RAS) based on age, gender and disability status in 1994. In addition, effective 1996, consumers gained the freedom to choose among hundreds of existing health plans, across employers and state-borders. This paper (a) estimates RAS pass-through rates on premiums, financial reserves, and expenditures and assesses the overall RAS impact on market price dispersion. Moreover, it (b) characterizes health plan switchers and investigates their annual and cumulative switching rates over time. Our main findings are based on representative enrollee panel data linked to administrative RAS and health plan data. We show that sickness funds with bad risk pools and high pre-RAS premiums lowered their total premiums by 42 cents per additional euro allocated by the RAS. Consequently, post-RAS, health plan prices converged but not fully. Because switchers are more likely to be white collar, young and healthy, the new consumer choice resulted in more risk segregation and the amount of money redistributed by the RAS increased over time.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128071344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Online weight-loss communities have become increasingly popular among individuals who want to lose weight. Social support and self-monitoring are two components found to be critical in facilitating successful weight-loss outcomes in these platforms. Although the direct impact of social support upon health has been studied extensively, the indirect impact of social support is underexplored. In this study, we include one important mediator, self-monitoring activities, to examine the effectiveness of social support on individuals’ weight-loss outcomes via both direct and indirect pathways. Drawn from theories of social support, social reciprocity, and social indebtedness, we differentiate social support as perceived and received support. We find, through empirical analysis, that both social support and self-monitoring are effective in promoting weight loss; however, perceived and received support operate through different pathways. Whereas both perceived and received support associate positively with weight-loss outcomes, received support associates negatively with self-monitoring activities. These findings can help healthcare providers and practitioners to leverage efforts in advising individuals’ self-management. Our results can also be used to help service providers in designing more effective online interventions.
{"title":"The Kindness of Commenters: An Empirical Study of the Effectiveness of Perceived and Received Support for Weight-Loss Outcomes","authors":"L. Yan","doi":"10.2139/ssrn.2949344","DOIUrl":"https://doi.org/10.2139/ssrn.2949344","url":null,"abstract":"Online weight-loss communities have become increasingly popular among individuals who want to lose weight. Social support and self-monitoring are two components found to be critical in facilitating successful weight-loss outcomes in these platforms. Although the direct impact of social support upon health has been studied extensively, the indirect impact of social support is underexplored. In this study, we include one important mediator, self-monitoring activities, to examine the effectiveness of social support on individuals’ weight-loss outcomes via both direct and indirect pathways. Drawn from theories of social support, social reciprocity, and social indebtedness, we differentiate social support as perceived and received support. We find, through empirical analysis, that both social support and self-monitoring are effective in promoting weight loss; however, perceived and received support operate through different pathways. Whereas both perceived and received support associate positively with weight-loss outcomes, received support associates negatively with self-monitoring activities. These findings can help healthcare providers and practitioners to leverage efforts in advising individuals’ self-management. Our results can also be used to help service providers in designing more effective online interventions.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124831943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health insurance, as a general insurance product, is becoming very popular in the present day fast track knowledge world. People around are getting no time and labor to muster the money to cover the risk of health disorders. Hence health insurers are pitching in with the customized products. The insured are becoming relieved persons and they specialize in their own task, thus contributing positively to the national economy. The study major thrust area like product innovation service delivery and customer relationship management. The survey is conducted in the city of Mysore by taking 158 respondents and three hypotheses, viz health insurance business in Mysore city is effective, health insurance has significant positive assessment from highly educated persons and income and perceptions towards are positively correlated are proved by using statistical tools.
{"title":"Effectiveness of Health Insurance - an Empirical Study in Mysore City","authors":"K. Suresha, V. S, V. Srinivas","doi":"10.2139/ssrn.2929268","DOIUrl":"https://doi.org/10.2139/ssrn.2929268","url":null,"abstract":"Health insurance, as a general insurance product, is becoming very popular in the present day fast track knowledge world. People around are getting no time and labor to muster the money to cover the risk of health disorders. Hence health insurers are pitching in with the customized products. The insured are becoming relieved persons and they specialize in their own task, thus contributing positively to the national economy. The study major thrust area like product innovation service delivery and customer relationship management. The survey is conducted in the city of Mysore by taking 158 respondents and three hypotheses, viz health insurance business in Mysore city is effective, health insurance has significant positive assessment from highly educated persons and income and perceptions towards are positively correlated are proved by using statistical tools.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128681639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Rossouw, Teresa Bago d'Uva, E. van Doorslaer
In spite of the well-known wide disparities in wealth and in objective measures of health like mortality in countries like South Africa, health inequality by wealth in self-reported health measures appears to be nearly non-existent. We test and correct for reporting heterogeneity in sixteen domains of self-assessed health by wealth and race among elderly South Africans using anchoring vignettes. We find that significant reporting differences between high and low wealth groups lead to severe underestimation of the health-wealth gap: poorer individuals rate the same health relatively higher than richer. Using hierarchical ordered probit (HOPIT) modeling, we show that a significant and substantial health disadvantage of the poor emerges after correction. We also address the question whether and how health inequality and reporting heterogeneity are confounded by race. We find that within race groups - especially among Blacks but also among Whites - reporting heterogeneity leads to the underestimation of the health inequalities between richest and poorest. Finally, we show that the apparent Black (vs White) health disadvantage within the top wealth quintile disappears once we correct for reporting tendencies. All in all, our findings suggest that reporting tendencies are an important source of bias in the measurement of health disparities and that anchoring vignettes and HOPIT models can play a role in correcting for these biases.
{"title":"Poor Health Reporting? Using Vignettes to Recover the Health Gradient by Wealth","authors":"Laura Rossouw, Teresa Bago d'Uva, E. van Doorslaer","doi":"10.2139/ssrn.2932778","DOIUrl":"https://doi.org/10.2139/ssrn.2932778","url":null,"abstract":"In spite of the well-known wide disparities in wealth and in objective measures of health like mortality in countries like South Africa, health inequality by wealth in self-reported health measures appears to be nearly non-existent. We test and correct for reporting heterogeneity in sixteen domains of self-assessed health by wealth and race among elderly South Africans using anchoring vignettes. We find that significant reporting differences between high and low wealth groups lead to severe underestimation of the health-wealth gap: poorer individuals rate the same health relatively higher than richer. Using hierarchical ordered probit (HOPIT) modeling, we show that a significant and substantial health disadvantage of the poor emerges after correction. We also address the question whether and how health inequality and reporting heterogeneity are confounded by race. We find that within race groups - especially among Blacks but also among Whites - reporting heterogeneity leads to the underestimation of the health inequalities between richest and poorest. Finally, we show that the apparent Black (vs White) health disadvantage within the top wealth quintile disappears once we correct for reporting tendencies. All in all, our findings suggest that reporting tendencies are an important source of bias in the measurement of health disparities and that anchoring vignettes and HOPIT models can play a role in correcting for these biases.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121748535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.12778/235108618x15452373185912
Petcharaporn Chatchawanchancha
This quantitative researched was purposed to examine factors affecting access to health service of Myanmar labours in Ranong Province, Thailand, with a population of 300 Myanmar labours in Ranong, using a questionnaire of 0.79 confidence level. Data analysis employed statistics of mean, standard deviation, correlation coefficient, and structural equation modelling. The study found that independent variables of public health management, service readiness, and information perception correlated with dependent variable of health services access at 0.46, 0.33, and 0.67, respectively. Hypothesis testing through structural equation modelling as per empirical data revealed that all three variables significantly (p =.05) affected Myanmar labours’ access to health service.
{"title":"Factors Affecting Access to Health Service Management of Transnational Myanmar Labours in Ranong, Thailand","authors":"Petcharaporn Chatchawanchancha","doi":"10.12778/235108618x15452373185912","DOIUrl":"https://doi.org/10.12778/235108618x15452373185912","url":null,"abstract":"This quantitative researched was purposed to examine factors affecting access to health service of Myanmar labours in Ranong Province, Thailand, with a population of 300 Myanmar labours in Ranong, using a questionnaire of 0.79 confidence level. Data analysis employed statistics of mean, standard deviation, correlation coefficient, and structural equation modelling. The study found that independent variables of public health management, service readiness, and information perception correlated with dependent variable of health services access at 0.46, 0.33, and 0.67, respectively. Hypothesis testing through structural equation modelling as per empirical data revealed that all three variables significantly (p =.05) affected Myanmar labours’ access to health service.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116627716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Insurance product choice is a central feature of health insurance markets in the United States, yet there is ongoing concern over whether consumers choose appropriately in such markets – and little evidence on solutions to any choice inconsistencies. This paper addresses these omissions from the literature using novel data and a series of policy interventions across school districts in the state of Oregon. Using data on enrollment and medical claims for school district employees, we first document large choice inconsistencies, with the typical employee foregoing savings of more than $600 in their insurance plan choice. We then consider three types of interventions designed to improve choice quality. We first show that interventions to promote more active choice are unlikely to improve choice quality based on existing patterns of plan switching. We then implement a randomized trial of decision support software to illustrate that it has little impact on plan choices, largely because of consumer avoidance of the recommendations. Finally, we show that restricting the choice set size facing individuals does significantly reduce their foregone saving and total costs. This is not because individuals choose worse with larger choice sets, but rather because larger choice sets feature worse choices on average that are not offset by individual re-optimization.
{"title":"Improving the Quality of Choices in Health Insurance Markets","authors":"Jason Abaluck, J. Gruber","doi":"10.3386/w22917","DOIUrl":"https://doi.org/10.3386/w22917","url":null,"abstract":"Insurance product choice is a central feature of health insurance markets in the United States, yet there is ongoing concern over whether consumers choose appropriately in such markets – and little evidence on solutions to any choice inconsistencies. This paper addresses these omissions from the literature using novel data and a series of policy interventions across school districts in the state of Oregon. Using data on enrollment and medical claims for school district employees, we first document large choice inconsistencies, with the typical employee foregoing savings of more than $600 in their insurance plan choice. We then consider three types of interventions designed to improve choice quality. We first show that interventions to promote more active choice are unlikely to improve choice quality based on existing patterns of plan switching. We then implement a randomized trial of decision support software to illustrate that it has little impact on plan choices, largely because of consumer avoidance of the recommendations. Finally, we show that restricting the choice set size facing individuals does significantly reduce their foregone saving and total costs. This is not because individuals choose worse with larger choice sets, but rather because larger choice sets feature worse choices on average that are not offset by individual re-optimization.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129173544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare is an important public policy concern in all countries. Effective delivery of healthcare to all the people is always a major challenge faced by many including India. The present twin modes in this country - public and private healthcare systems- combined together remains grossly inadequate to meet the constantly increasing healthcare demands of the large population, a majority of whom live in rural areas. In the wake of continuing incapacity of existing systems and impacting factors like cost, access etc., need arises to find out ‘new ways and structures’ of delivery of healthcare.Globally, healthcare co-operatives, are being viewed as ‘third realm’ of healthcare system and already new interest in such co-operatives is growing. India’s experience in the co-operative movement in general spans more than a century. Moreover, co-operatives in different health segments - hospitals, health education, training in health work, paramedical, health insurance - have already been tried in different states (Kerala, Gujarat, Bengal, Punjab, Tamil Nadu) since 1920s. Of course, the previous Indian experience in healthcare co-operatives presents a mixed bag of success and failures.In the context of the failure of existing modes of healthcare delivery, in the light of growing global interest in healthcare co-operatives and in the background of the country’s earlier experience in this sphere, it becomes highly relevant to renew focus on co-operatives, rectifying the defects identified so far. This articles argues a case for establishing ‘the third realm’ in healthcare, the healthcare co-operatives in India.
{"title":"Healthcare Co-Operatives: Possible Third Realm of Healthcare in India","authors":"R.M Devasoorya, S. V. Srinivasa Vallabhan","doi":"10.2139/SSRN.2860548","DOIUrl":"https://doi.org/10.2139/SSRN.2860548","url":null,"abstract":"Healthcare is an important public policy concern in all countries. Effective delivery of healthcare to all the people is always a major challenge faced by many including India. The present twin modes in this country - public and private healthcare systems- combined together remains grossly inadequate to meet the constantly increasing healthcare demands of the large population, a majority of whom live in rural areas. In the wake of continuing incapacity of existing systems and impacting factors like cost, access etc., need arises to find out ‘new ways and structures’ of delivery of healthcare.Globally, healthcare co-operatives, are being viewed as ‘third realm’ of healthcare system and already new interest in such co-operatives is growing. India’s experience in the co-operative movement in general spans more than a century. Moreover, co-operatives in different health segments - hospitals, health education, training in health work, paramedical, health insurance - have already been tried in different states (Kerala, Gujarat, Bengal, Punjab, Tamil Nadu) since 1920s. Of course, the previous Indian experience in healthcare co-operatives presents a mixed bag of success and failures.In the context of the failure of existing modes of healthcare delivery, in the light of growing global interest in healthcare co-operatives and in the background of the country’s earlier experience in this sphere, it becomes highly relevant to renew focus on co-operatives, rectifying the defects identified so far. This articles argues a case for establishing ‘the third realm’ in healthcare, the healthcare co-operatives in India.","PeriodicalId":309156,"journal":{"name":"PSN: Health Care Delivery (Topic)","volume":"295 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116224121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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