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Political economy of development of health care system in post-colonial India

By: Jha, Binod Kumar.
Material type: materialTypeLabelBookPublisher: Bihar Journal of Public Administration Description: 19(25), Jul-Sep, 2022: p.138-145.Subject(s): Post-colonial, Neo-liberal, Structural adjustment programme (SAP), Welfare state, Market economies In: Bihar Journal of Public AdministrationSummary: In post-colonial India, health system has been shaped by two competing ideological frameworks of political economy:- welfare economy of pre liberalisation era, and market economy of neo-liberal variant thereafter. Although during the later year of this period, few private players were promoted with state incentives to act as an alternate provider. During the early years, since health sector being integral to the overall development planning, thus influenced by the social goals, but later on as a result of acceptance of IMF’s structural adjustment programme (SAP), many structural reforms were erupted in the economy including in the health sector. As a result, the dominance of public health care was curtailed at the cost of private health care system on the plea of achieving resource efficiency and accommodating consumer choice, these resulted in a cut in the public health care expenditure. The element of privatisation, started earlier went more deeper in the National Health Policy (2015), where the health sector gets transformed from a service providing sector to an instrument of economic growth. The current model of health care is that of a system dominated by the private sector with differential access mechanism, thereby dismantling its universalistic, egalitarian and costeffective character. The crisis in the health system reflects the inadequacy of the institutional democracy to the lives of the people and thus the crisis of politics which underlines it and provides support to anti-people policies. – Reproduced
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Articles Articles Indian Institute of Public Administration
19(25), Jul-Sep, 2022: p.138-145 Available AR128893

In post-colonial India, health system has been shaped by two competing ideological frameworks of political economy:- welfare economy of pre liberalisation era, and market economy of neo-liberal variant thereafter. Although during the later year of this period, few private players were promoted with state incentives to act as an alternate provider. During the early years, since health sector being integral to the overall development planning, thus influenced by the social goals, but later on as a result of acceptance of IMF’s structural adjustment programme (SAP), many structural reforms were erupted in the economy including in the health sector. As a result, the dominance of public health care was curtailed at the cost of private health care system on the plea of achieving resource efficiency and accommodating consumer choice, these resulted in a cut in the public health care expenditure. The element of privatisation, started earlier went more deeper in the National Health Policy (2015), where the health sector gets transformed from a service providing sector to an instrument of economic growth. The current model of health care is that of a system dominated by the private sector with differential access mechanism, thereby dismantling its universalistic, egalitarian and costeffective character. The crisis in the health system reflects the inadequacy of the institutional democracy to the lives of the people and thus the crisis of politics which underlines it and provides support to anti-people policies. – Reproduced

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