Where the math is defensible.
Long-form research on live enterprise decisions. Publication is selective. Every number traces to a named source. No takes without evidence.
India Ayushman Bharat at five years: coverage, claims, and the OOP question
PMJAY has issued more than 360 million health cards and authorized over 90 million hospital admissions, yet out-of-pocket spending still funds nearly two of every five rupees of Indian health care. The next phase will be judged less by enrollment than by whether the scheme bends the household cost curve.
Five years after Pradhan Mantri Jan Arogya Yojana (PMJAY) went national, India has built the largest publicly funded health assurance program in the world, covering roughly 550 million people on paper and authorizing claims worth more than 1.4 trillion rupees through early 2026. Coverage and utilization have grown rapidly, but state-level...
Kenya health financing 2026: SHIF rollout, fiscal arithmetic, donor cliff
The Social Health Insurance Fund inherits NHIF's debts and Kenya's universal coverage ambitions just as PEPFAR, Global Fund, and Gavi rewrite the rules of co-financing. The arithmetic is brutal, but tractable.
Kenya replaced the National Hospital Insurance Fund with the Social Health Insurance Fund in October 2024, anchoring universal coverage on a 2.75 percent salary deduction and a means tested contribution for informal workers. Eighteen months later, enrollment has climbed past 22 million principal members, but only a fraction are paying. Pr...