Research

Working Papers :

This paper evaluates the impact of a national social health insurance scheme, named Rashtriya Swasthya Bima Yojana (RSBY) rolled out in India in 2008 for poor households on utilization of health services and per-capita out-of-pocket expenditures. Using a large nationally representative panel data based on a household survey and difference-in-difference estimation strategy, we find that RSBY increased the likelihood of hospitalization by 1.3 percentage points and it led to a greater proportion of members in a household opting hospitalization for long term illness. We also find that RSBY households are 3.2 percentage points more likely to get themselves treated from a doctor for short-term illness. Our findings also show that monthly per-capita total OOP expenditure of households increases by 37 percent. This occurs due to more patient-doctor contact among RSBY households and they becoming more aware of their health care needs. Using quantile difference-in-difference estimation strategy as proposed by Koenker and Bassett (1978) and Chernozhukov and Hong (2002), we also find that this increase in expenditure is higher at the top conditional distribution of OOP spending. On the other hand, the positive impacts of increased hospitalization and receiving treatment from doctor is reflected through the fact that number of days lost due to illness decreases. Further, using a battery of robustness tests we ensure that the results are indeed driven by implementation of RSBY.

In the last several decades, the proportion of the population aged 65 and above has nearly doubled across OECD countries from 9 percent in 1960 to more than 17 percent in 2017. Additionally, trade in health services has grown in the recent past and the benefits from increased trade in health services is mostly reaped by the aged population of a country which requires a significant portion of the medical services. Therefore, we conduct a panel data analysis of 36 OECD countries for the period 2005-2017 to find the impact of old age-dependency ratio on trade in health services. Using dynamic panel data models, we find that age dependency ratio has a negative and significant impact on trade balance of medical services and the impact is more pronounced in countries with lesser number of hospital beds. The driving force behind this is the drop in exports of health services due to higher age dependency ratio. With higher old age dependency ratio in the home country, the need for medical attention in the home country increases which probably crowds out exports of health services to foreign countries but increases imports from foreign countries. Also, the fall in exports is higher as compared to rise in imports of health services leading to a negative impact on trade balance of health services

In the eighteenth century, the East India Company introduced Italian filature technology to the silk reeling industry of Indian province of Bengal in order to produce silk suitable for the European market. The experiment failed in Bengal despite its superiority over the traditional method and eventually moved to Japan in the late nineteenth century – almost a century later it arrived in Bengal – and was successfully adopted there. In this paper, drawing on the Japanese case, we examine the reasons behind filature’s failure in Bengal. We focus on the role of micro-innovation in technology adoption and argue that in Bengal’s case the East India Company failed to provide incentive for such micro-innovation because of their dual status as the monopoly trader and de-facto ruler of Bengal. Japanese silk industry on the other hand was

characterized by competition which played a key role in the successful technology adoption.

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