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WELCOME. By Prof.S.Chakraborty Director Jaipuria Institute of Management Lucknow, INDIA. GOAL OF DEVELOPMENT. Social justice something that goes beyond Economic Growth. Development happens through. Income security Securities against contingencies Environmental security. From

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Welcome

WELCOME

By

Prof.S.Chakraborty

Director

Jaipuria Institute of Management

Lucknow, INDIA.


Goal of development

GOAL OF DEVELOPMENT

Social justice

something that goes beyond

Economic Growth


Development happens through

Development happens through

  • Income security

  • Securities against contingencies

  • Environmental security


Shifts in employment patterns

From

Having people on rolls

Job growth in the organized sector

To

Buying service from people.

Job growth in the unorganized sector

Shifts in Employment patterns


Fallouts

Fallouts

  • Lack of clear cut employer – employee relationship

  • Increasing income insecurity

  • Vulnerability of the workers


Social security social integration and health

Social Security, social integration and health

  • Mortality, morbidity and life expectancy – all directly influenced by standards of living.

  • Strong association between income inequality and excess mortality.

  • Two – way casual relationship between health and wealth.


Need of the hour

Need of the hour

Social protection

Eradication of problems not just prevention of a decline

Sophisticated forms of targeting and monitoring

Innovations in the social sector.


Health care delivery scene in india

Health care delivery scene in India

  • Faced with the dual challenge of ‘diseases of poverty’ and ‘diseases of prosperity’

  • Real vs articulated demand

  • Public spending ratio is 1:3 between the poorest 20% and the richest 20%


Estimates of household expenditures treatment costs per episode per year in india

Estimates of household expenditures/treatment costs per episode/per year in India


Key challenges

Key challenges

  • Creating efficiently targeted policies with widespread public participation

  • Integration of social and economic policies

  • Keeping the cost of administration low

  • ‘Prevention’ against increases in deprivation


Welcome 4317747

  • ‘Promotion’ of better chances of individual development

  • Intensifying focus towards ‘needy’ (contribution or no contribution)

  • Shifting away from large scale universal systems


Need of a focus shift in social security

Need of a focus shift in social security

in order to

  • enhance and protect peoples’ capabilities

  • provide benefits through public or collective arrangements

  • help people to cope with various insecurity dimensions

    -poverty levels

    -casualization of employment

    -gender inequality

  • improve opportunities and choices before individuals.


Poverty

Poverty

Poverty is not just a state of deprivation.

It is equally a state of vulnerability


Market oriented interventions in the health sector

Market – oriented interventions in the health sector

Does the assumption of ‘perfect market’ work?

Perhaps can work only when – those with greatest need are also those with most resources


Key assumptions in market functioning

Key assumptions in market functioning

  • Perfect information

  • Free entry and exit

  • Fair distribution of income with all having an ability to pay


Scenario in health sector

Scenario in Health Sector

Wide range of market failures because of

  • high element of risk and uncertainty

  • moral hazard

  • adverse selection

  • externalities

  • assymetrical distribution of income


The big question

The big question

Does the market – oriented health – care systems actually work?


Health care through social security schemes

Health care through social security schemes

Displayed characteristics

  • Have an urban orientation

  • Caters to those in the organized sector


Employees covered under different system number in millions

Employees covered under different system (number in millions)


Low income organized sector workers

Low – income organized sector workers

  • For these workers there is a mandatory, contributory scheme known as Employee State Insurance Scheme (ESIS) run by Employee State Insurance Corporation (ESIC)

  • As on March 31, 2006, ESIC covered around 8.5 million insured persons/family units


Notable features of esis

Notable features of ESIS

  • Workers with a salary of less than Rs.10000 per month can join

  • Workers earning less than Rs.50 a day (approximately $ 1) are exempt from contributing


Typology of risk pooling schemes in india today

Typology of Risk Pooling Schemes in India Today


Quality of service

Quality of Service

Some common complaints are

  • long queues

  • non – availability of good quality medicines

  • problems with reimbursement

  • non – availability of service in certain geographical regions


Health security

Health security

  • Requires to ensure low exposure to risk

  • Provides access to healthcare services along with ability to pay


Burden of treatment

Burden of treatment

Equals

Cost of treatment + loss of income

However

Little attention has been paid to the burden factor


Does health insurance answers the need

Does health insurance answers the need?

  • Perhaps yes, for those who can afford to pay when they are healthy

  • Apparently no, when it comes to the poorer section


Social security needs in developing countries

Social security needs in developing countries

  • To ensure that members of the society meet their basic needs as well as remain protected from contingencies.

  • To enable members maintain a standard of living consistent with social norms.


What does it call for

What does it call for?

Greater emphasis on social justice and social rehabilitation

not limited to

only medical rehabilitation.


Envisaged needs

Envisaged needs

  • Innovations in social sectors to make life better for our millions

  • Focus on indigenous development with local expertise on local problems with local content of local relevance

  • To create economic and social developments from below


Recent developments

Recent Developments

  • Universal health insurance scheme of Govt. of India (focussed on BPL section)

  • Yeshasvani Co-operative health care scheme in Karnataka (mainly focussed on farmers)

  • Innovations in Arvind eye care centre, Madurai, Tamil Nadu (brought down the cost of cataract operations)

  • Kudumbashree programme in Kerala (state poverty eradication mission)

  • Grassroots innovation augmentation programme (GIAN)

  • ………… and many more


Welcome 4317747

Efforts of late …….

are in the right direction


India is on the move showing signs that

India is on the move showing signs that

  • People have learnt to escape from old ideas

  • Serious note has been taken of what Amartya Sen had said, “Development without participation is a sin.”


As a consequence

As a consequence

‘I’ in India has started changing

It is no longer

  • Immitation and inhibition

    Instead it is

  • Innovation and Creation of value from ideas


Welcome 4317747

Thank You


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