Health care services in India: A few questions on equity

This paper analyzes equity in health care utiliza-tion and out-of-pocket expenditure on health care in India using two rounds (52th round 1995-1996 and 60th round 2004-2005) of National Sample Survey data and data from a household survey carried out in 2007. The findings indicate that the average hospitalization rate has increased and the corresponding value of the concentra-tion index has decreased over the last ten years. However, the health care payment structure is seen to be regressive for inpatient care, and more so for outpatient care. The main reason is the very high out-of-pocket payment on medi-cine and diagnostic tests even in government hospitals. High out-of-pocket payment has re-sulted in 34 percent poor households losing all their past savings, 30 percent of households borrowing with interest and 2 percent of house-holds selling their assets. These findings indi-cate the urgent need for putting in place risk pooling mechanisms