Asymmetric Fiscal Federalism and Public Provision of Healthcare: New Insights from India

K. S. Harikrishnan and Gourishankar S. Hiremath

Indian Journal of Human Development, 2023, vol. 17, issue 3, 420-438

Abstract: In this article, we show undesirable consequences of a market-based system and argue for a public provision of healthcare. We examine the healthcare provision from the fiscal federalism perspective. With the asymmetric fiscal federal structure characterised by vertical and horizontal imbalances, states are dependent on transfers from union to provide public goods. Our analysis shows a widespread disparity in the public provision of healthcare in India due to fiscal imbalances. The performance of states in the management of the COVID-19 pandemic reveals that a robust public healthcare system is a prerequisite in managing a health emergency. We identify the withdrawal of governments from healthcare provision and concentration of resources with the union government as critical impediments to achieving universal healthcare access. In light of our analysis, we emphasise the need for resource devolution and cooperative federalism to ensure public provision for a dignified life in a functioning democracy.

Keywords: Equity; fiscal federalism; human development; public provision; universal healthcare (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/09737030241239736 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:inddev:v:17:y:2023:i:3:p:420-438

DOI: 10.1177/09737030241239736

Access Statistics for this article

More articles in Indian Journal of Human Development
Bibliographic data for series maintained by SAGE Publications ().