Privatisation of Health Care in India - Indian Institute of Public ...

Privatisation of Health Care in IndiaTable 12: Trend in Utilisation of Outpatient Services in the Private SectorBetween 42 nd and 52 nd Rounds of the NSS(Percentage)States 42 nd (Urban 42 nd (Rural) 52 nd (Urban) 52 nd (Rural) Change Urban Change RuralMaharashtra 72.4 70.5 77 73 +4.6 +2.5Karnataka 65 60 74 51 +9 -9Orissa 42.4 31 53 31 +10.6 No changeINDIA 50 50 72 64 +22 +14Source: Compiled from Duggal (2006: 34-35)Table 13: Trends in Utilisation of Inpatient Services in the Private Sector Between42 nd and 52 nd Round of the NSS(Percentage)States 42 nd (Urban) 42 nd (Rural) 52 nd (Urban) 52 nd (Rural) Change Urban Change RuralMaharashtra 48 54 68.2 68.8 +20.2 +14.8Karnataka 50 38 78.2 54.2 +20.2 +16.2Orissa 15 7 19 9.4 +4 + 2.4INDIA 36 35 56.9 54.7 +20.9 +19.7Source: Compiled from Duggal (2006: 34-35)increase (Table 13). This trend needs to be analysed furthernot only in the context of the increase in the growth ofprivate services, but also in terms of what has been happeningin the public sector. The issues concerning risingcosts in the public sector, the quality of care provided, andincrease in the costs of drugs have acted as push factorsfor utilising the private sector. What is indeed worrying isthat the STs across states have shown very low levels ofutilisation. This would mean that those who need care arenot seeking care, because they cannot afford it and thereforemay not be seeking care when they need it the most(Sen et al, 2002). In a sense, while the middle and uppermiddle classes can choose to use either the public or privatesectors, the poor may not be in a position to accesseither of them, because of the rising costs of medical care.Where the public sector is weak, this will definitely affectutilisation by the poorer sections of the population. Clearlythere are important questions regarding equity in this context.At the state level this calls for a rational use of availableresources and also for a policy that will strengthenpublic provisioning and regulate the private sector. In addition,other mechanisms like public insurance schemescould be given a serious thought to address some of theseinequities and their consequences.28