Understanding the Paradox of Primary Health Care Use: Empirical Evidence from India

Pramod Sur

Papers from arXiv.org

Abstract: I study households' primary health care usage in India, which presents a paradox. I examine why most households use fee-charging private health care services even though (1) most providers have no formal medical qualifications and (2) in markets where qualified doctors offer free care through public hospitals. I present evidence that this puzzling practice has deep historical routes. I examine India's coercive forced sterilization policy implemented between 1976 and 1977. Utilizing the unexpected timing of the policy, multiple measures of forced sterilization, including at a granular level, and an instrumental variable approach, I document that places heavily affected by the policy have lower public health care usage today. I also show that the instrument I use is unrelated to a battery of demographic, economic, or political aspects before the forced sterilization period. Finally, I explore the mechanism and document that supply-side factors do not explain these differences. Instead, I demonstrate that places with greater exposure to forced sterilization have higher confidence in private hospitals and doctors to provide good treatment.

Date: 2021-03, Revised 2022-07
New Economics Papers: this item is included in nep-dev, nep-hea and nep-ias
References: Add references at CitEc
Citations: View citations in EconPapers (2)

Downloads: (external link)
http://arxiv.org/pdf/2103.13737 Latest version (application/pdf)

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:arx:papers:2103.13737

Access Statistics for this paper

More papers in Papers from arXiv.org
Bibliographic data for series maintained by arXiv administrators (help@arxiv.org).