Is Government Health Subsidy Targeted Enough in India? Evidence from a Tertiary Hospital

ABSTRACT

In emerging economies like India, the focus of public health policies is shifting toward the treating non-communicable diseases to preventing communicable diseases. The public welfare demands appropriate targeted healthcare subsidies for non-communicable diseases. In this paper, we investigate whether out-of-pocket expenditure toward mitigating non-communicable diseases for the poorer section of the population is catastrophic by nature. In a representative futuristic scenario for an emerging economy, we have collected the cancer patients’ expenditure data from the patients and hospital management in a not-for-profit cancer hospital located in the state of Kerala. We have analyzed the variation of expenditure categorized as government subsidy toward treatment, private expenditure toward medical goods and services, and private expenditure toward non-medical goods and services against different socio-economic variables. The analysis of catastrophic health expenditure data reveals that relatively lower income lower-income households face more risk of catastrophic health expenditure and are in greater need of government subsidy.

KEYWORDS:

• Catastrophic health expenditure
• public health policy
• cancer
• Kerala
• out-of-pocket expenditure

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. We have compared the distribution of the people who remained in the study to the corresponding distribution of the people under attrition, in terms of income level and educational attainment, arguably two important variables of socio-economic profile of a respondent. We have performed the Kolmogorov Smirnov test, a standard non-parametric way of statistical comparison of two distributions for both of these variables. For income level, the statistic and p-value for the null hypothesis of equality of distributions are 0.0136 and 1.000, respectively, which implies that the income distribution of both the groups are definitely the same. For educational attainment, those values are 0.0440 and 0.919, again concluding to the similarity of the two groups in terms of educational attainment.

2. The value of total wealth comprises of two principal components, physical wealth and financial wealth. The former constitutes the values of primary residence, land, livestock, crops and jewelry while the latter represents net savings/investments in banks and non-banking financial institutions.

Additional information

Funding

The work was supported by the Indian Institute of Management Kozhikode [MGRP/2018/R2]; IIM Kozhikode Medium Grant 2018 [MGRP/2018/R2].