Public-private Partnerships in Health Services in India: Arogyasri as a Benchmark

Public-private partnerships in the domain of public service delivery have become hallmark ever since India opened its economy to the global market. This has been the case particularly with health services, both in urban and rural areas. India's southern state of Andhra Pradesh is implementing the Aarogyasri (health services) programme which is very popular with the masses. In this mode of health services delivery, corporate hospitals handle the biggest share of the cases. Unfortunately, there is no provision for day-to-day services (out patient) which in fact could have made this programme all encompassing. The focus on tertiary healthcare to the exclusion of all other forms of medical assistance leads to an inefficient medical care model with lesser impact on meeting the needs of majority of the people. There is need for a debate on the healthcare and techno-commercial performance of the programme, especially if it is going to be copied by other states and even by the centre in introducing some form of universal healthcare under the National Rural Health Mission. The scheme aims to provide medical care for BPL families up to a value of 0.2 million (Indian, National Rupees) per annum for tertiary surgical and medical treatment of serious ailments, which, in turn, will help them from excessive private borrowing. The scheme is run by a public-private partnership called the Aarogyasri Health Care Trust between Star Health and Allied Insurance, the corporate hospitals and state agencies. This partnership has, however, come to an end in early March 2013. Medical and health services in the private sector are unregulated and where obstetrics is the single largest specialization. The present study is of exploratory in nature and will try to assess the dimensions of PPPs in the health. sector where public funding is mostly poor. It will also explain the impact of collaborations on the general reach of health services in the state of Andhra Pradesh where the government's role has virtually become defunct.