Choice of poor people towards the type of health care services (public or private) has not been much discussed. This is mainly because of the underlying assumption that their choice has always been restricted to public health care services. The inefficiency of the public health care system in India has created a vacuum among the poor people regarding their preference for health care. Their tendency to transform from accessing public to private health care services is discussed in this context.
The study was conducted among the low-income urban households of Kerala. It was noted that there is a strong willingness among these categories to access private health care services. Efficiency of the health care services was pointed out as a major reason for this. However, issues such as the high cost of private health care services remain unresolved. An option to revamp the public health care system cannot materialise especially when the budget allocation for public health service has reduced considerably. In this context, a proposal for an integrated system, which would work on distributive and redistributive mechanisms is suggested.
Adams, R. (2007). Democrats eager to cut private stake in medicare . CQ Weekly, 65(2), 108–9 .
2.
Armstrong, D. (2007). California tests a template for health insurance . CQ Weekly, 65(4), 227–8 .
3.
Barber, S.L. , P.J. Gertler and P. Harimurti (2006–07). Differences in access to high-quality outpatient care in Indonesia . Health Affairs, 26, 352–66 .
4.
BC Business (2007). Perils and profits, 35(8), 40 .
5.
Carol, P. (2000). The demand for private health care in the UK . Journal of Health Economics, 19(6), 855–76 .
6.
Centre for Development Studies (CDS) (2005). Human development report—Kerala. State Planning Board, Government of Kerala .
7.
Cohn, J. (1999). Live a little . New Republic, 220(23), 6 .
8.
Cole, C.R. and K.A. McCullough (2006). A review of the issues surrounding fair share health care bills . Journal of Insurance Regulation, 25(1), 25–40 .
9.
Das, J. and J. Hammer (2006–07). Location, location, location: Residence, wealth, and the quality of medical care in Delhi, India . Health Affairs, 26, 338–51 .
10.
Dunn, P. (2007). Can big business save health care?Hospitals & Health Networks, 81(1), 38–46 .
11.
Economic Review(2006). Kerala State Planning Board, Thiruvananthapuram , pp. 335–46 .
12.
Finance Week(2004). ‘ A world-class national asset ’, p. 48 .
13.
Gehshan, S. (2008). Foundations’ role in improving oral health: Nothing to smile about . Health Affairs, 27(1), 281–7 .
14.
Geisel, J. (2007). California next in line for health care reform . Business Insurance, 41(18), 3–80 .
15.
Gertler, P. and R. Sturm (1997). Private health insurance and public expenditures in Jamaica . Journal of Econometrics, 77(1), 237–57 .
16.
Good, B. (2006). Enough health-care rhetoric . BC Business, 34(8), 110 .
17.
Government of India (2003). Health information of India. Delhi Central Bureau of Health Intelligence, Directorate General of Health Services, Ministry of Health and Family Welfare .
18.
Haughey, J. (2005). Private hospitals lead temporary healthcare spending slump . Building Design & Construction, 46(6), 15 .
19.
Hickie, I.B. , T.A. Davenport and G.M. Luscombe (2006). Mental health expenditure in australia: Time for affirmative action mental health expenditure in australian & New Zealand . Journal of Public Health, 30(2), 119–22 .
20.
Jean-Frédéric, L. , H. Slim , N. Delampady and F. Pierre (2006). Outpatient care utilization in urban Kerala . India Health Policy and Planning, 21(4), 289–301 .
21.
Kannan, K.P. , K.R. Thankappan and V. Ramankutty (1991). Health and development in rural Kerala. Thiruvananthapuram, India KSSP .
22.
Kerala Economic Review (2006). Government of Kerala, State Planning Board, Thiruvananthapuram.
23.
Krishnan, T.N. (1999). Access to health and the burden of treatment in India: An inter-state comparison, In Rao M (ed). Disinvesting in health: The World Bank’s prescriptions for health, pp. 208–32. New Delhi: SAGE Publications .
24.
Kumar, G.B. (1993). Low mortality and high morbidity in Kerala reconsidered . Population and Development Review, 19(1), 103–21 .
25.
Linda, K. (2003). Current health care strategies target access, affordability—yet again . National Underwriter/Life & Health Financial Services, 107(31), 33 .
26.
Mantshantsha, S. (2007). Denial or wishful thinking? . Finweek, p. 20 .
27.
Mathers, C.D. , C.J. Murray , L. Sadana , R. Tandon , A., Lopez , A.D, Ustün, B ; Chatterji, S. and Salomon J.A. (2003). Healthy life expectancy: Comparison of OECD countries in 2001 . australian & New Zealand Journal of Public Health, 27(1), 5–11 .
28.
Meng-Kin, L. , Y. Hui , Z. Tuohong , F. Wen and Z. Zijun (2004). Public perceptions of pri-vate health care in socialist China . Health Affairs, 23(6), 222–34 .
29.
Moberly, H. Dean (1991). Health care for low income persons: An analysis of demand . Journal of Economics & Finance, 15(1), 53 .
30.
Narayana, D. (2001). The mixed health care system in Kerala: quality or price competition? India Centre for Development Studies (Unpublished document).
31.
Oommen, M.A. (2008). Reforms and the Kerala model . Economic and Political Weekly, 43(2), 22–5 .
32.
Peacock, D. , N. Devlin and R. McGee (1999). The horizontal equity of health care in New Zealand . australian & New Zealand Journal of Public Health, 23(2), 126–31 .
33.
Plant, A. (2005). International challenges in health—can we succeed?australian & New Zealand Journal of Public Health, 29(6), 505–6 .
34.
Porter, M.E. and E.O. Teisberg (2004). Redefining competition in health care . Harvard Business Review, 82(6), 64–76 .
35.
Schorr, D. (2002). Compassion suspended . New Leader, 85(6), 4 .
36.
Sen, A. (1995). Rationality and social choice . American Economic Review, 85(1), p 1–24 .
37.
Swift, S. (2007). Can we get well and stay well?Retailing Today, 46(June and July), p 7–7 .
38.
Varadarajan, D. (2003). Public sector and efficiency: Are they mutually exclusive? An alternative policy framework to improve the efficiency of public health care system in Tamil Nadu, India . Journal of Health & Population in Developing Countries, 14 July, p. 14 .
