Bijoya Roy , Siddharta Gupta
Issue : VOL 46 No. 38 September 17 – September 23, 2011
Increasing cost of medical care has emerged as the second biggest cause of rural indebtedness in India. A user fee at the point of service delivery is now common even at the basic primary healthcare level. Focusing on rural hospitals in West Bengal, this article examines the structure of user fees and compares it across a set of basic diagnostic services delivered by public sector healthcare institutions, public-private partnerships and the private sector. Revised user charges, and a restrictive exemption and waiver policy under the PPP framework has produced exclusionary effects in the primary healthcare system in the state.