研究取消纸币和实施商品与服务税对印度医疗服务的影响

S. M. Ghosh
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摘要

本文探讨了2016-2017年8个月内实施的纸币禁令和商品及服务税对印度自报疾病和医疗消费的影响。研究结果表明,1995-1996 年至 2014 年自报疾病的增加趋势在 2017-2018 年发生了逆转。2014 年至 2017-2018 年期间医疗消费的减少主要发生在私人医疗领域,而非公共医疗领域,这表明纸币禁令和商品及服务税引发的经济压力是其原因。在职业弱势群体中,自我报告的疾病和医疗消费减少的时间更长。即使在禁钞令实施一年半后,报告疾病、医疗消费和医疗自付支出的减少仍在继续;这也可能因后来商品及服务税的实施而加剧。数据显示,2014 年至 2018 年间,公共医疗状况有所恶化。因此,尽管弱势群体获得私人医疗服务的机会减少,但他们也无法求助于公共医疗服务,导致整体医疗消费减少。本文的研究结果呼吁在印度建立一个强大的、正常运作的、可负担得起的公共医疗保健系统,以增强抵御危机的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examining the effect of removing banknotes and implementing Goods and Services Tax on access to healthcare in India
This paper explores the effect of the banknote ban and GST, which were implemented within a span of 8 months in 2016-2017, on self-reported illnesses and healthcare consumption in India. The findings show that the increasing trend of self-reported illness from 1995-96 to 2014, reversed in 2017-2018. The reduction in healthcare consumption between 2014 and 2017-2018 is primarily within the private care sector rather than public care, indicating economic duress induced by the banknote ban and GST as its cause. The reduction in self-reported illness and healthcare consumption is more prolonged among the occupationally vulnerable. The reduction in reporting of illnesses, healthcare consumption, and out-of-pocket expenditure on health continued even after one-and-half years of the banknote ban; this may also have been exacerbated later by the implementation of GST. Data indicate that the condition of public healthcare deteriorated between 2014 to 2018. As a result, even though the weaker sections’ access to private healthcare diminished, they could not turn to public healthcare either, resulting in a reduction in overall healthcare consumption. The findings of this paper call for a robust, functioning, affordable public healthcare system in India for greater crisis resilience.
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