Sunday Health Policy UpDate
April 9, 2006
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Insurance In Developing Countries

India's Medical 'Brain Drain'

Utah Medicaid Waiver


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New postings and analysis from Health Affairs, the leading journal of health policy. Health Affairs publishes new research each week online at For more information, contact Chris Fleming at 301-347-3944.

Private Coverage Could Protect Residents of Developing Countries

A report in the March/April Health Affairs considers the potential benefits of private health insurance in poor countries, and how this could be fostered, including through subsidies. Mark Pauly and colleagues argue that the money residents of these countries already spend out-of-pocket on health care could be used more effectively to buy health insurance, allowing families to survive medical problems without sacrificing their children's education or their stores of seed and fertilizer.

Print editions of Health Affairs may be ordered for $35 each from Health Affairs' Customer Service at 301-347-3900 or online at

Mullan Examines India's Medical "Brain Drain"

The persistent loss of physicians to lucrative jobs in developed countries is hurting India's efforts to meet the health needs of its massive and often poorly served citizenry, according to Fitzhugh Mullan's report in the March/April Health Affairs. His analysis of India's medical brain drain-almost 60,000 India-trained physicians have emigrated to wealthy nations-concludes with a call for India to do more to retain its medical talent and for industrialized countries to reduce their reliance on foreign-born physicians by boosting spending on medical education.

Authors Cite Limitations of Medicaid Expansions Financed Through Benefit Cuts

Also in the March/April Health Affairs, Samantha Artiga and colleagues say that more than three-fourths of the low-income adults in Utah's Primary Care Network reported needing benefits beyond the scope of their coverage. The authors say that coverage through the PCN is narrow because the state, in its 2002 Medicaid waiver, elected to finance expanded primary care solely by cutting benefits for existing Medicaid beneficiaries, rather than utilizing broader revenue sources as other states have elected to do.


Health Affairs, published by Project HOPE, is the leading journal of health policy. The peer-reviewed journal appears bimonthly in print with additional online-only papers published weekly as Health Affairs Web Exclusives at The full text of each Health Affairs Web Exclusive is available free of charge to all Web site visitors for a two-week period following posting, after which it switches to pay-per-view for nonsubscribers. The abstracts of all articles are free in perpetuity. Web Exclusives are supported in part by a grant from the Commonwealth Fund.


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