Understanding How Markets and State Action Shape Costs and Prices of Healthcare in Post-globalization India: A Study of High-end Imaging Services in Kerala

摘要

Globalization has pressurized the developing nations to open their health sector for profit-driven private investors-both domestic and foreign. In a private sector dominant unregulated healthcare market like India, the service providers are free to determine the fee for services. In the present policy context of the role of central government shifting to strategic purchasing of services from the private sector (National Health Policy, 2017) and discussions on regulation of prices in private healthcare markets, an understanding of the cost of services and its relationship to prices is essential. Very few attempts have been made to estimate the cost of advanced diagnostic services; those done have most often used the traditional costing methods. Bottom-up micro-costing method which is considered as the gold standard in hospital costing is used in this study to estimate the cost of three services: CT scan, MRI scan and Cath-Lab in three districts of Kerala. A comparison with the per capita income of the population is also attempted to analyse the contextual differences in costs and prices.