The Centre for Social and Economic Progress hosted a Seminar on the Association Between Public Financing of Health, Health Seeking Behaviour and Out-of-Pocket Expenditure on Thursday, August 10, 2023. Attendees joined in-person at the CSEP Auditorium (6 Jose P Rizal Marg, 2nd Floor, Chanakyapuri, New Delhi – 110021) and online via Zoom. The seminar was streamed live on YouTube.

About the event:

Public allocations to healthcare diverge across states with wide differentials in out-of-pocket expenditure on health and on health-seeking behaviour. Disaggregating across states reveals that an increase in government spending has not necessarily led to a decrease in out-of-pocket expenditure.  Even where the utilisation of public health facilities has increased with increasing government spending, this has not necessarily led to declining private expenditure. Focusing on specific states is important to understand the context of high out-of-pocket expenditure even where public facility utilisation is high, the excessive use of private facilities where public expenditure is high, and if and how state economic level drives health-seeking behaviour.

The seminar will discuss the association between government spending on healthcare and out-of-pocket expenditures to assess if increases in the former have led to decreases in the latter. The discussion will explore the hypothesis that the association between government health expenditure and out-of-pocket expenditure is mediated by the utilisation of services (public versus private). 

Chair:

Laveesh Bhandari is President and a Senior Fellow at CSEP. He has been leading climate change and sustainability research at CSEP and has published widely on subjects related to sustainable livelihoods, industrial, economic and social reforms in India, economic geography and financial inclusion. He has taught economics at Boston University and IIT Delhi. He has been the managing editor of the Journal of Emerging Market Finance and worked at the National Council of Applied Economic Research (NCAER), New Delhi.

Panelists:

C K Mishra was former Secretary in the Ministry of Environment, Forest and Climate Change, Government of India and the Ministry of Health & Family Welfare. He has led one of the largest public health programmes globally and his contribution to policy changes which helped India see large reductions in maternal and child mortality, and positive intervention in non-communicable diseases, is well known. He is globally recognised for his significant contributions to improving the Indian Public Health landscape. He also spearheaded the Indian efforts at addressing climate change issues and at policy interventions in matters relating to pollution and air quality. In about 37 years of public service, he has served as an administrator, policymaker and public health strategist holding a wide range of assignments in the fields of health, education, industry and power. He held leadership positions as head of many international organizations relating to maternal child health (PMNCH), tobacco control (FCTC), population stabilization etc.

Girija Vaidyanathan, a career civil servant, has wide experience in implementation and financing development sector schemes, having spent nearly fifteen years in various leadership positions in the Health, Nutrition and Environment sectors. She retired as Chief Secretary, Government of Tamil Nadu. In the position, she was responsible for health policy formulation and played an important role in system improvement in functional areas such as maternal and child health, TB control, public funded insurance, data systems, food and drug safety and in the design and sanction of the Tamil Nadu Health Systems Project. During her years in the Finance Department, she was responsible for the financing of health, education and other social sector schemes. She has numerous academic publications to her name and serves on the governing bodies of various academic and non-governmental organizations like the VHS (Honorary Treasurer), Bala Mandir Kamaraj Trust, Public Health Foundation of India, SCARF and the Madras Institute of Development Studies.

Nachiket Mor is trained as an economist. His current work is principally focused on the design of national and regional health systems. He is a Visiting Scientist at The Banyan Academy of Leadership in Mental Health and a Senior Research Fellow at the Centre for Information Technology and Public Policy at IIIT Bangalore. He is also a Commissioner on the Lancet Citizens’ Commission on Reimagining India’s Health System.

Rajeev Sadanandan is the CEO of the Health System Transformation Platform. He had worked as the health secretary of Kerala state, CEO of Rashtriya Swasthya Bima Yojana (RSBY), India’s national social health insurance programme in addition to holding many other positions in state and central governments. He was responsible for many transformative reforms in Kerala’s health sector. He also worked briefly stint in UNAIDS and has been a member of technical committees set up by UNAIDS and WHO. He has recently been appointed as a member of the Technical Advisory Panel of The Pandemic Fund set up to help countries build resilience to future pandemics.

Closing Remarks:

Indrani Gupta is a Professor and Head of the Health Policy Research Unit of the Institute of Economic Growth (IEG), Delhi, India. She received her PhD in Economics from the University of Maryland, College Park, USA. She set up a centre for health economics and policy research in her institute, the first of its kind in India. Her work experience has been diverse, including teaching and academic institutes, the World Bank and the Government of India. Her areas of interest cover a wide range of topics in the area of health economics and policy and include demand for health and health care, health financing, poverty and health, economics of diseases, costing and cost-effectiveness.

Moderator:

Sandhya Venkateswaran is a Senior Fellow at the Centre for Social and Economic Progress (CSEP) and leads the Human Development work at CSEP, with a specific focus on Health Policy. In a career spanning over three decades, she has worked on a wide range of issues in the social sector across health, nutrition, gender, natural resources, urban development and others, and has authored books, multiple articles and other publications on varied social sector issues. Over the last 15 years, her focus has been on policy issues, developing and leading the policy and advocacy portfolio in organisations such as the Bill and Melinda Gates Foundation, Global Alliance for Improved Nutrition and CARE. She has worked with grassroots campaigns and civil society organisations, as well as with government and international organisations. She is currently a member of the Lancet Citizens’ Commission on Reimagining India’s Health System.

Presenter:

Alok Kumar Singh is a Research Associate in the health vertical at CSEP. He has completed his MPhil in Public Health from the Tata Institute of Social Sciences, Mumbai, and MA in Development Studies (specialization Public Policy) from Azim Premji University, Bengaluru. Prior to CSEP, he worked as a researcher with the Abdul Latif Jameel Poverty Action Lab, National Centre for Biological Sciences – Tata Institute of Fundamental Research, and also as a manager with Reliance Industries Limited, Mumbai.

Please contact Alok Kumar at AKumar@csep.org for event-related inquiries or Trishna Wahengbam at TWahengbam@csep.org for media inquiries.

All content reflects the individual views of the speakers. The Centre for Social and Economic Progress (CSEP) does not hold an institutional view on any subject.