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Health Financing in India

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Health Financing in India
Institute for Financial Management and Research Centre for Insurance and Risk Management

Delivering Micro Health Insurance Through the National Rural Health Mission
A Strategy Paper

Rupalee Ruchismita, Imtiaz Ahmed and Suyash Rai

August 2007

Rupalee Ruchismita (rupalee.ruchismita@ifmr.ac.in) and Imtiaz Ahmed (imtiaz@ifmr.ac.in) are with the Centre for Insurance and Risk Management at IFMR, Chennai (http://ifmr.ac.in/cirm). Suyash Rai is with the ICICI Centre for Child Health and Nutrition, Pune. The views expressed in this note are entirely those of the authors and do not in any way reflect the views of the Institutions with which they are associated.

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Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission

Contents
1 Introduction 2 Health Financing in India 3 Key issues in Health Financing 4 Exploring Risk Transfer and Pooling Strategies 5 Proposal for a National Apex Body 6 Conclusion 7 Annexures 7.1 ANNEXURE I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.2 ANNEXURE II . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3 Objectives, Activities, and Services . . . . . . . . . . . . . . . . . . . . . . . . 1 1 3 4 8 13 14 14 19 22

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Ruchismita, Ahmed, Rai: Delivering Micro Health Insurance through the National Rural Health Mission

1 Introduction
The Indian health scenario is fairly complex and challenging with successful reductions in fertility and mortality offset by a significant and growing communicable as well noncommunicable disease burden1 , persistently high levels of child undernutrition2 , increasing polarisation in the health status of the rich and the poor3 and inadequate primary health care coexisting with burgeoning medical tourism! This situation is further complicated by the presence and practice of multiple systems of medicine and medical practitioners (several of whom are not formally certified and recognised) and

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