TALK SESSION ON UNIVERSAL PENSIONS AND HEALTH SECURITY

American Centre and United States - India Educational Foundation (USIEF) organized a talk on ‘Universal Pensions and Health Security in the United States and in India: Challenges Ahead’ on 28th April, 2014 at the American Centre Auditorium, New Delhi. Dr. Abhishek Swami, Associate Professor, Department of Applied Science, Dronacharya Group of Institutions, Greater Noida attended the talk.

The event featured the work of two researchers – Brookings India Fellow Prof. Shamika Ravi, Economics and Finance, Indian School of Business and Prof. Ken Apfel, Fulbright-Nehru Senior Scholar and Faculty, University of Maryland.

Prof. Apfel’s discussed on a macro perspective on the health sector in the United States and India, and included lessons for India from the American experience. He told that insurance and pension schemes are very costly propositions. The increase in the insurance and pension cover in the United States has come at a significant cost, for instance, social security expenditure has increased from 2% in 1960 to 4% in 2000, and expected to touch 5% in 2020. Apfel’s explained that in India, the total expenditure on pension and health security is expected to increase to 5-6% of the GDP, on account of universal health coverage, and social pensions and retirement savings.

He discussed that one of the most significant lessons from the United States’ experience is the importance of a strong public governance system to ensure health quality at a reasonable cost. Such governance is particularly important in the public-private model used in the United States, and increasingly in India. Prof. Apfel’s told that the governance of insurance has not received much attention in India – the central and state governance apparatus is fragmented, and insurance is overseen by very small ‘nodal’ agencies. According to Prof. Apfel’s existing insurance schemes have been criticized for producing perverse incentives that cause health providers to expand services, implying that in the absence of oversight and accountability, costs are expected to see a huge increase in the future.

Prof. Ravi discussed the micro aspects of health insurance, sharing her research findings on the impact of various state funded insurance schemes and drawing lessons from microfinance. Prof. Ravi’s discussion was embedded in an overarching understanding that health coverage in India must be restructured and expanded. She quoted the WHO reports that among countries with national health insurance programs, India has one of the highest out-of-pocket healthcares spending, indicating that there are gaps in the current programs that must be ameliorated.

The vote of thanks of was delivered by Mr. Subir Gokarn, Director of Research, Brookings India.