Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 73
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::printArticle() - APP/Controller/ArtileDetailController.php, line 73
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Deprecated (16384): The ArrayAccess methods will be removed in 4.0.0.Use getParam(), getData() and getQuery() instead. - /home/brlfuser/public_html/src/Controller/ArtileDetailController.php, line: 74
 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php. [CORE/src/Core/functions.php, line 311]
Code Context


        trigger_error($message, E_USER_DEPRECATED);

    }
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 You can disable deprecation warnings by setting `Error.errorLevel` to `E_ALL & ~E_USER_DEPRECATED` in your config/app.php.'
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deprecationWarning - CORE/src/Core/functions.php, line 311
Cake\Http\ServerRequest::offsetGet() - CORE/src/Http/ServerRequest.php, line 2421
App\Controller\ArtileDetailController::printArticle() - APP/Controller/ArtileDetailController.php, line 74
Cake\Controller\Controller::invokeAction() - CORE/src/Controller/Controller.php, line 610
Cake\Http\ActionDispatcher::_invoke() - CORE/src/Http/ActionDispatcher.php, line 120
Cake\Http\ActionDispatcher::dispatch() - CORE/src/Http/ActionDispatcher.php, line 94
Cake\Http\BaseApplication::__invoke() - CORE/src/Http/BaseApplication.php, line 235
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\RoutingMiddleware::__invoke() - CORE/src/Routing/Middleware/RoutingMiddleware.php, line 162
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Routing\Middleware\AssetMiddleware::__invoke() - CORE/src/Routing/Middleware/AssetMiddleware.php, line 88
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Error\Middleware\ErrorHandlerMiddleware::__invoke() - CORE/src/Error/Middleware/ErrorHandlerMiddleware.php, line 96
Cake\Http\Runner::__invoke() - CORE/src/Http/Runner.php, line 65
Cake\Http\Runner::run() - CORE/src/Http/Runner.php, line 51
Cake\Http\Server::run() - CORE/src/Http/Server.php, line 98

Warning (512): Unable to emit headers. Headers sent in file=/home/brlfuser/public_html/vendor/cakephp/cakephp/src/Error/Debugger.php line=853 [CORE/src/Http/ResponseEmitter.php, line 48]
Code Context
            if (Configure::read('debug')) {

                trigger_error($message, E_USER_WARNING);

            } else {
$response = object(Cake\Http\Response) {

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		&#039;subheading&#039; =&gt; &#039;&#039;,
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-The Hindu&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
&lt;/div&gt;&#039;,
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Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...&#039;,
	&#039;disp&#039; =&gt; &#039;&lt;div align=&quot;justify&quot;&gt;-The Hindu&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;&lt;br /&gt;If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;&lt;br /&gt;Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Pooling of expenditure&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;&lt;br /&gt;Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot; title=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;&lt;/div&gt;&#039;,
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&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
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	&#039;credit_writer&#039; =&gt; &#039;The Hindu, 21 March, 2017, http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&#039;,
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Strategic shifts are needed in the level of government control on the financing and provision of health

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Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data..."/>
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                <strong>Framing the right prescription for health expenditure -Saachi Bhalla &amp; Nachiket Mor</strong></h1>
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                <div align="justify">-The Hindu<br /><br /><em>Strategic shifts are needed in the level of government control on the financing and provision of health<br /></em><br />India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br /><br />If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br /><br />Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br /><br /><em>Pooling of expenditure<br /></em><br />First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br /><br />Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true" title="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br /></div>               </font>
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-The Hindu&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
&lt;/div&gt;&#039;,
		&#039;credit_writer&#039; =&gt; &#039;The Hindu, 21 March, 2017, http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&#039;,
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Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...&#039;,
	&#039;disp&#039; =&gt; &#039;&lt;div align=&quot;justify&quot;&gt;-The Hindu&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;&lt;br /&gt;If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;&lt;br /&gt;Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Pooling of expenditure&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;&lt;br /&gt;Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot; title=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;&lt;/div&gt;&#039;,
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&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
&lt;/div&gt;&#039;,
	&#039;credit_writer&#039; =&gt; &#039;The Hindu, 21 March, 2017, http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&#039;,
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-The Hindu

Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...&#039;
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-The Hindu

Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data..."/>
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                <strong>Framing the right prescription for health expenditure -Saachi Bhalla &amp; Nachiket Mor</strong></h1>
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                <div align="justify">-The Hindu<br /><br /><em>Strategic shifts are needed in the level of government control on the financing and provision of health<br /></em><br />India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br /><br />If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br /><br />Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br /><br /><em>Pooling of expenditure<br /></em><br />First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br /><br />Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true" title="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br /></div>               </font>
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-The Hindu&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
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-The Hindu

Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...&#039;,
	&#039;disp&#039; =&gt; &#039;&lt;div align=&quot;justify&quot;&gt;-The Hindu&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;&lt;br /&gt;If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;&lt;br /&gt;Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Pooling of expenditure&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;&lt;br /&gt;Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot; title=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;&lt;/div&gt;&#039;,
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&lt;br /&gt;
&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;
&lt;br /&gt;
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;
&lt;br /&gt;
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;
&lt;br /&gt;
&lt;em&gt;Pooling of expenditure&lt;br /&gt;
&lt;/em&gt;&lt;br /&gt;
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;
&lt;br /&gt;
Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;
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-The Hindu

Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...&#039;
$disp = &#039;&lt;div align=&quot;justify&quot;&gt;-The Hindu&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Strategic shifts are needed in the level of government control on the financing and provision of health&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&amp;rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&amp;rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.&lt;br /&gt;&lt;br /&gt;If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.&lt;br /&gt;&lt;br /&gt;Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.&lt;br /&gt;&lt;br /&gt;&lt;em&gt;Pooling of expenditure&lt;br /&gt;&lt;/em&gt;&lt;br /&gt;First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&amp;rsquo;s tax allocation to health and insurance coverage in the country. India&amp;rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&amp;rsquo; State Insurance Scheme (ESIS) &amp;mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &amp;mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.&lt;br /&gt;&lt;br /&gt;Please &lt;a href=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot; title=&quot;http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true&quot;&gt;click here&lt;/a&gt; to read more. &lt;br /&gt;&lt;/div&gt;&#039;
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Strategic shifts are needed in the level of government control on the financing and provision of health

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                <strong>Framing the right prescription for health expenditure -Saachi Bhalla &amp; Nachiket Mor</strong></h1>
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                <div align="justify">-The Hindu<br /><br /><em>Strategic shifts are needed in the level of government control on the financing and provision of health<br /></em><br />India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br /><br />If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br /><br />Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br /><br /><em>Pooling of expenditure<br /></em><br />First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br /><br />Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true" title="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br /></div>               </font>
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-The Hindu<br />
<br />
<em>Strategic shifts are needed in the level of government control on the financing and provision of health<br />
</em><br />
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br />
<br />
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br />
<br />
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br />
<br />
<em>Pooling of expenditure<br />
</em><br />
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br />
<br />
Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br />
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Strategic shifts are needed in the level of government control on the financing and provision of health

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-The Hindu<br />
<br />
<em>Strategic shifts are needed in the level of government control on the financing and provision of health<br />
</em><br />
India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br />
<br />
If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br />
<br />
Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br />
<br />
<em>Pooling of expenditure<br />
</em><br />
First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br />
<br />
Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br />
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$metaTitle = 'LATEST NEWS UPDATES | Framing the right prescription for health expenditure -Saachi Bhalla &amp; Nachiket Mor'
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-The Hindu

Strategic shifts are needed in the level of government control on the financing and provision of health

India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data...'
$disp = '<div align="justify">-The Hindu<br /><br /><em>Strategic shifts are needed in the level of government control on the financing and provision of health<br /></em><br />India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India&rsquo;s peers, the lower-middle-income countries 4.5%. By these measures, India&rsquo;s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries.<br /><br />If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons.<br /><br />Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system.<br /><br /><em>Pooling of expenditure<br /></em><br />First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government&rsquo;s tax allocation to health and insurance coverage in the country. India&rsquo;s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees&rsquo; State Insurance Scheme (ESIS) &mdash; currently a mandatory insurance scheme only for low-wage earners in the formal sector in India &mdash; to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea.<br /><br />Please <a href="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true" title="http://www.thehindu.com/opinion/op-ed/framing-the-right-prescription-for-health-expenditure/article17545892.ece?homepage=true">click here</a> to read more. <br /></div>'
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Framing the right prescription for health expenditure -Saachi Bhalla & Nachiket Mor

-The Hindu Strategic shifts are needed in the level of government control on the financing and provision of health India spends close to 5% of its GDP on health. While this may appear low when compared to 18% of the U.S., data show that Organisation for Economic Co-operation and Development (OECD) countries spend 8-11%, middle-income countries close to 6%, and India’s peers, the lower-middle-income countries 4.5%. By these measures, India’s health-care spending, while still somewhat low, is not unusually so. However, on an index measuring country performance on the health-related Sustainable Development Goal (SDG) indicators, India ranks poorly at 143 out of 188 countries. If we look in terms of Purchasing Power Parity (PPP), a measure that more accurately corresponds with our actual standard of living, India is the third largest economy in the world, at almost PPP $8 trillion. Given the large size of our population, our 5% allocation to health translates to a mere $267 per individual, a number far lower than the OECD average of $4,698. Yet, countries with comparable or even lower per capita health expenditures, including Indonesia, Thailand, and Ghana, are ranked better on the SDG Index at 91, 112, and 141, respectively, out of 188, and offer us hope and a few lessons. Interestingly, two of the most important differences between India and these countries are the extent of pooling of health expenditures and the level of government control of the health system. Pooling of expenditure First is the pooling of health expenditure: India has among the lowest pooled expenditure for health care; between 2004-2014, approximately 4-7% of households fell below the poverty line as a result of high out-of-pocket expense. Pre-payment and pooling of resources are critical to ensure financial protection against catastrophic health shocks. The extent of pooling is determined by the government’s tax allocation to health and insurance coverage in the country. India’s low tax to GDP ratio and allocations of around 5% of general government expenditure to health impact the total quantum of funds available. Countries such as Thailand which have a comparable tax to GDP ratio have prioritised health within their budgets and allocate 13% of it to health care. To increase pooled funds for health care, India needs to both provide a significantly higher level of allocation to health care in its annual Budgets, as in Thailand, as well as extend schemes such as the Employees’ State Insurance Scheme (ESIS) — currently a mandatory insurance scheme only for low-wage earners in the formal sector in India — to all employees. Gradually the informal sector, both in upper and lower income, can be included by making it mandatory for all residents to buy into national or state health insurance schemes as has been successfully done in Kyrgyzstan, China, and South Korea. Please click here to read more.