Abstract:

Despite expenditure of 4% of GDP in 2012 on health, India failed to attain the Millennium Development Goals (MDGs) targets through the public sector structure alone. The article investigated the existing gaps between provision and access to health care by constructing the health infrastructure index (HII) and health attainment index (HAI) of two states of West Bengal (WB) and Maharashtra (MAH). Performance of three outreach programs was evaluated including; the Fair Price shops (FPS), the Rashtriya Swasthya Bima Yojana (RSBY), and the National Rural Telemedicine Network (NRTN).

Maharashtra (MAH) had infrastructure uniformly spread with higher HAI than WB meaning that creating better health infrastructure leads to attainment of better heath. Hospitalization costs under the RSBY were higher for WB which had a high morbidity than MHA. Expansion of NRTN to remote places reduced on the non-medical costs incurred. The FPS was implemented only in WB and it allowed access to affordable medicines.

Combined implementation of the FPS, NRTN and RSBY yielded high benefit, addressing inadequacies in infrastructure, personnel and high cost of treatment including out of pocket expenditure. Therefore, the only hope lies in public private partnership (PPP).

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