The Best Laid Plans: Access to the Rajiv Aarogyasri community health insurance scheme of Andhra Pradesh
DOI:
https://doi.org/10.5195/hcs.2014.163Palabras clave:
Health insurance, India, Aarogyasri, Qualitative assessmentResumen
This paper is a qualitative assessment of a public health insurance scheme in the state of Andhra Pradesh, south India, called the Rajiv Aarogyasri Community Health Insurance Scheme (or Aarogyasri), using the case-study method. Focusing on inpatient hospital care and especially on surgical treatments leaves the scheme wanting in meeting the health care needs of and addressing the impoverishing health expenditure incurred by the poor, especially those living in rural areas. Though well-intentioned, people from vulnerable sections of society may find the scheme ultimately unhelpful for their needs. Through an in-depth qualitative approach, the paper highlights not just financial difficulties but also the non-financial barriers to accessing health care, despite the existence of a scheme such as Aarogyasri. Narrative evidence from poor households offers powerful insights into why even the most innovative state health insurance schemes may not achieve their goals and systemic corrections needed to address barriers to
health care.
Citas
Aarogyasri Health care Trust. http://www.aarogyasri.gov.in/ (Accessed February 17, 2014)
Barnard, H. Russell. Research Methods in Anthropology: Qualitative and Quantitative Approaches. Walnut Creek: Altamira Press. 1995.
Bourdieu, Pierre. Outline of a theory of practice. Cambridge: Cambridge University Press. 1977.
Ergler, Christina R, Patrick Sakdapolrak, Hans-Georg Bohle, and Robin A Kearns. “Entitlements to health care: Why is there a preference for private facilities among poorer residents of Chennai, India?” Social Science and Medicine. 72 (2011): 327-337. doi- 10.1016/j.socscimed.2010.09.042
Fan V, Karan A, Mahal A. “State Health Insurance and Out of-Pocket Health Expenditures in Andhra Pradesh, India.” CGD Working Paper 298.Washington, D.C.: Center for Global Development. 2012 http://www.cgdev.org/content/publications/detail/1426275 (Accessed March 15 2013)
George, A., & Aditi Iyer. Unfree markets: Socially embedded informal health providers in northern Karnataka, India. Social Science & Medicine 96 (2013): 297-304. http://dx.doi.org/10.1016/j.socscimed.2013.01.022
Inhorn, Marcia. Quest for Conception: Gender, Infertility and Egyptian Medical Traditions. Philadelphia: University of Pennsylvania Press. 1994
Janzen, John. The Quest for Therapy in Lower Zaire. Berkeley: University of California Press.1982.
Krishna, Anirudh. “Escaping Poverty and Becoming Poor: Who Gains, Who Loses, and Why?” World Development. 32 (2004): 121–136. doi:10.1016/j.worlddev.2003.08.002
Nambiar, Devaki. “India’s “Tryst” with Universal Health coverage: Reflections on Ethnography in Indian Health Policymaking”. Social Science and Medicine. 99 (2013):135-42. 10.1016/j.socscimed.2013.08.022
Narasimhan, Haripriya. “Where there is no doctor: Narratives on biomedical healthcare practitioners in Chennai, South India”. In Multiple Voices and Stories: Narratives of Health and Illness ed. Arima Mishra and Suhita Chopra Chatterjee. New Delhi: Orient Blackswan. 2013.
Nandraj, Sunil. “Beyond the law and the lord: quality of private health care.” Economic and Political Weekly. 29 (1994):1680-1685.
Prasad, Purendra, N and P. Raghavendra. “Healthcare Models in the era of Medical Neo-liberalism: A Study of Aarogyasri in Andhra Pradesh”. Economic and Political Weekly. 47 (2012): 118-126.
Rao, Mala, S. S. Ramachandra, S. Bandyopadhyay, A. Chandran, R. Shidhaye, S. Tamisettynarayana, A. Thippaiah, Sitamma M., M. Sunil George, V. Singh, S. Sivasankaran, S. I. Bangdiwala. “Addressing the healthcare needs of people living below the poverty line: A rapid assessment of the Andhra Pradesh Health Insurance
Scheme”. National Medical Journal of India 24 (2012): 335-341
Reddy, Sunita and Immaculate Mary. “Aarogyasri Scheme in Andhra Pradesh, India: Some Critical reflections.” Social Change. 43 (2013): 245-261.
Van Hollen, Cecilia. Birth on the threshold: childbirth and modernity in south India. Berkeley: University of California Press. 2003.
World Health Organisation. http://www.who.int/nha/atlas.pdf (accessed on January 10, 2014)
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