Page 22 - Htain Manual

One of the
Chart-2 Share of Govt & Households in Total
objectives of NRHM was Health Expenditure in India
Share of Govt Share of Hhs
to reduce financial

hardships and 100
90
impoverishments of 80
70 78 68
60
households on account
50
40
of healthcare access by
30
20 20 29
improving public health
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services through 2004-05 2013-14
focussed investments. Targeted approach and non-lapsing budgets for certain areas under

NRHM, not only improved the access but also the quality of a number of primary care services.

As a result, there is a considerable change in the composition of government and household
health expenditures as revealed through respective National Health Account Reports 2004

and 2014 (Chart-2)

Recent Initiatives

Pooling of health risks is suggested as one of the mechanisms to mitigate the

household burden. As of now, a very small proportion of the population is covered through

insurance programs for health care. While publicly financed health insurance is still in an early

stage, the private insurance programs are even more limited in coverage, being mainly
confined to urban areas and high income segments of the population. A number of publicly

funded health insurance schemes of different scales and package of services have been

launched over the last two decades. These include the Rashtriya Swasthya Bima Yojana (RSBY)
by the government of India which has a focus on secondary healthcare and expanded versions

of RSBY in Kerala, Chhattisgarh and Himachal Pradesh. These also cinlude Aarogyasri by the

Government of Andhra Pradesh, Chief Minister’s Health Insurance Scheme by Tamilnadu and

similar schemes by different states which focus on tertiary health care. Experiences gained

through implementation of these schemes and the need to bring-in strategic reforms in
health care sector forced the government to move towards a National Health Protection

Scheme. After a number of committees, reports and debates over the last few years, the

Government of India recognised the fact that a publicly funded insurance scheme with

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