Fiscal Instruments for Health in India
Authors: Amit Summan, Nicholas Stacey, Karen J. Hofman, Ramanan Laxminarayan
This chapter presents the analytic framework for assessing the potential of fiscal instruments to improve population health, describing the application of this method to specific interventions in India and discussing the implications of these policy changes in order to inform policies at ministries of finance that have an effect on health. The primary determinants of population health and health inequalities, particularly in low- and middle-income countries (LMICs), lie outside of the health care system and include individual-level factors—such as access to clean water and sanitation, nutrition, and antenatal care—as well as environmental-level factors—such as pollution, rates of open defecation, and tariffs on food imports and exports. Although direct public health expenditures undoubtedly play an integral role in determining population health, health outcomes remain determined by the complex interactions of social, economic, biological, and environmental factors, and a wide range of viable fiscal policy interventions could modify these proximate factors, which could prove particularly useful when governments find themselves unable to expand direct health care expenditures.
In Table 19.4 found on page 364, there are two corrections. First, in row 5 column 4, Tax Revenue Gains for the Sugar Sweetened Beverage (SSB) Tax should read $21,510 (CI: $19,717 - $23,889) million. Second, row 3, column 4, Deaths Averted for LPG subsidy removal should be 1.9 (CI: 1.2 – 2.4) million.