This volume is a comprehensive database on the health sector with respect to the outlays of four major states of India, namely, Gujarat, Maharashtra, Orissa, and Rajasthan for the period 1985-86 to 1994-95. The significance of this ten year period is that it can be used to assess the impact of the fiscal adjustment programme (beginning 1990-91) on this redistributive expenditure by analysing government financing of the health sector during the pre-and-post structural adjustment period .

Different models of health care systems including financing organisations and delivery being practised in some developed and developing countries are presented here. An attempt is made here to review the practices in selected developed and developing countries and to draw lessons, if any, for India

With a high percentage of population either unemployed or employed in the unorganized sectors, the health care systems in India are bound to be complex. The attempt here is to present some of the important health care systems prevailing in India. First the organizational set-up for health care is presented in brief. Then, health care financing and health care provision by sectors and by sources is described. The system as a whole is examined and areas for immediate attention identified.

Undertaken at the behest of the Department of Administrative Reforms and Public Grievances, this study has looked at the four principal legislations that govern property titling and property conveyance in India: The Transfer of Property Act, 1882; The Indian Succession Act, 1925; The Registration Act, 1908; The Indian Stamp Act, 1899.

The purpose of the review was to locate problems that citizens are faced with in securing ownership/title of a property or in conveyancing properties. The review of legislations reflected that there are serious problems in the existing legislative provisions, even as the term "property' is not adequately defined. None of the legislations defined categorically what title or ownership means, and under what conditions can a citizen secure absolute ownership. The nature of documents that are required to be presented for conveyance make legal transfers of properties (purchase/sale) extremely difficult. The study is preliminary, and lays foundation for a comprehensive examination of the property related laws in the country.

In the context of the ongoing external liberalisation as well as the multilateral trade negotiations under the auspices of the WTO, an urgent need to have a comprehensive database on customs tariff and tariff bindings was recognised. This would facilitate in serving objectives, such as to review customs tariff vis-a-vis our international commitments on tariff bindings, compare customs tariff with that in competing countries, compute tariff equivalent of non-tariff barriers, and estimate revenue effects of alternative revenue proposals. Further, a user-­friendly interactive programme can add value to such a database. The current database makes a small, but useful beginning in this direction. It focuses on customs tariff and tariff bindings for India for the year 1999-2000.

The small scale industries (SSIs) constitute a considerable part of total industrial pollution in India. The monitoring and enforcement of environmental laws on SSIs have, however, been highly unsatisfactory: The study focuses on ways of improving compli­ance from SSIs. The main objectives of the study are to: (i) examine the feasibility of combined treatment in controlling pollution from SSIs; and (ii) explore the feasibility of introducing incentive-based-cost-sharing arrangements. The study brings out that com­bined treatment is a cost-effecti ve option for SSIs. Thus, the subsidy for CETPs is justified. Recommended in the study are the various changes that should be effected in the existing system including the subsidy scheme for setting up CETPs, for environmental manage­ment in SSIs to become more effective. :

Health and human development form integral components of the overall socio-economic development of a nation. Measured in terms of the two most widely used indicators of health status, namely, (i) life expectancy at birth, and (ii) infant mortality rate, the health status in India has improved considerably over time. But, achievement has been limited compared to some other developing countries. For example, during 1960 and 1993, life expectancy at birth in India increased by only 38 percent against 46 percent in China, 53 percent in Indonesia and 34 percent in all developing countries. Infant mortality rate decreased by 51 percent in India as against 71 percent in China, 76 percent in Sri Lanka, 65 percent in Thailand, 82 percent in Malaysia (the lowest in developing countries being 13 percent). Health status in India is not only below that of many developing countries taken individually, but also below that of all developing countries taken together.

Recording an average per capita annual income of about Rs 6,200 (US $ 350), India is placed in the middle range of low-income countries. For a country with this level of income, India spends a relatively significant amount on health care, that is, 6 percent of the GDP, but the returns in terms of health improvement have been poor. Further, as compared to other countries barring a few developed nations, the total health expenditure in India is fairly high at$17,750 million in 1990. Other countries, such as China, Indonesia, Sri Lanka, and Malaysia which spend a smaller amount on health (not only in absolute terms but also in per capita terms) are found to have better health status in terms of infant mortality rates and life expectancy

Despite exemplary success in the sphere of human development, industrial growth in Kerala has been tardy. The state economy has been rendered vulnerable to volatility of remittances from abroad. Of late, unemployment and rural poverty have been relatively high and there has been decay in the infrastructure of education, and health built up over the years. Poor returns from the 105 State Level Public Enterprises (SLPEs) have resulted in persistent revenue and fiscal deficit and mounting debt to GSDP ratio. Kerala has embarked upon an ambitious Ninth Plan (Rs.16,100 crore at 1996-97 prices) with 35-40 per cent of the plan funds being allocated to various tiers of local bodies. The participation of local bodies in the preparation of projects and plans as well as administration of plan funds is the first of its kind in Indian states. This augurs well for the economic prospects of the state. Continuance of present trends under moderate growth, as captured in the base scenario implies a deepening fiscal crisis, even while the plan has to be cut down. In this backdrop, a reform package has been suggested in the report with a view to achieving a sustainable debt to GSDP ratio and higher growth rate. Fiscal reforms include setting the stage for gradual introduction of V A T, revamping of tax administration, tapping the potential of non-tax revenues, increase in non-salary main­tenance and capital outlay and no net growth of employment in the government sector. Sector reforms include automatic revision of tariff for transport and power, privatisation of distribution of power and downsizing and gradual weeding out of non-viable SLPEs. Profit-making enterprises need to be restructured and revitalised and possibilities of merger among similar ones may be explored.

Madhya Pradesh, like other states, has sought to promote industrial development by offering three types of fiscal incentives: capital investment subsidies; interest subsidies; and exemption/ deferment from sales tax. These concessions have imposed heavy costs on the state exchequer; the revenues foregone from such tax concessions alone could fund at least a dozen new growth centres each year (at Rs 35 crore per growth centre). In a scenario where different types of industrial incentives are superimposed on each other, the overall impact on investment is additive. The disentangling of the incremental impact of each has been attempted in two ways, using a database on investment in large and medium industry in the state. Both econometric exercises show that tax concessions failed to play an investment promoting role. The landmark multilateral agreement reached between chief ministers of states on 16 November, 1999, to remove sales tax concessions with effect from 1 January, 2000, is thus directly in line with the findings of this study. A further date for introduction of VAT has been set at 1 April, 200"1; a full-fledged VAT operated on the tax credit method is, with very few exceptions, incompatible with giving new units a differential tax advantage: The econometric results for the capital subsidy are more ambiguous. The slowing of the growth rate of real investment after 1988 cannot be ascribed solely to the replacement that year of the central government subsidy, which was available to large and medium industrial units, by the state subsidy scheme which (with some minor exceptions) was not available to large and medium units. There was also a sharp concurrent decline in power availability. Given the overwhelming importance of infrastructure in attracting industry into a state, the first best option is the redirection of fiscal resources from capital subsidies towards infrastructure provision (the November agreement between states does not include capital subsidies in its ambit). If this first-best alternative is not acceptable, it should be possible to redefine the base to include fixed investment in infrastructure alone. Alternatively, or in addition, the capital subsidy could be confined to a set of labor-intensive thrust industries.:

There is an urgent need to evolve a trade tax system that promotes efficiency in production and consumption that allows the development of an Indian common market and does not impair the competitiveness of the domestic producers vis-a-vis their foreign counterparts. In this context, the Institute has been advocating replacement of the existing system of sales tax by a value added tax. A workshop on VAT was organized during July 26-28,1999, with the support of DFID India and World Bank, to provide a forum for debate on the feasible design of VAT for the states of India. It was well attended, with participation from a large segment of state officials, officials from the Ministry of Finance and the Central Board of Excise and Customs (CBEC), representatives of trade and industry, and VAT experts from India and abroad. This report presents a brief summary of the deliberations at the workshop.

This study is an update of the earlier study on Government Subsidies in India, completed in 1997, and subsequently published.

The unduly large volume of subsidies (at more than 14 percent of GDP), and the subsidy regime in India was also critically evaluated in a Discussion Paper (DP) on "Government Subsidies in India" (May, 1997), as being non-transparent, inefficiently administered, poorly targeted, and regressive, leading to misallocation and waste of resources, while keeping government budgets in persistent imbalance. While the states accounted for the bulk of these subsidies (more than 2/3rds ), the remaining subsidies emanated from the central budget.

The study focused on discriminatory tax treatment of domestic vis-a-vis foreign products. Tax discrimination is identified in terms of effective rates of protection (ERP) and differential composite duty rates on imports and domestic products. Analyzing the central, state, and local taxes, the study reveals that even though most products are subject to high net protection, some products suffer competitive tax disadvantage in domestic as well as international markets because of inverted duty structure, input taxation without full set off and nil or low customs duty. A rationalization of the tax system to ensure level playing field between imports and domestic products, through immediate removal of all exemptions, end use concessions, and input taxation, along with phased reduction in high duty rates and their number is recommended. In fact, a minimum customs duty should apply to all imports including imports of products currently not produced in the country, for giving the right signal to domestic producers to venture into production of such products. The level of minimum duty can also be lowered in line with reduction in high duty rates.

The objective of this study is to analyze the effects of environment on the health of a community. It is postulated that the health status of a community is a 'conceptual variable' which cannot be measured directly but is indirectly determined by the civic and socio-economic environment of the people and the physico-natural environment of the region.

Part A of this study is focused on the health situation in the union territory/National Capital Territory (UT/NCT) of Delhi. Chapter II discusses briefly the demographic features of Delhi and Chapter III the mortality data as obtained from the annual reports on registration of births and deaths (1984 to 1994) published by the Chief Registrar (births and deaths), Government of UT/NCT of Delhi; and morbidity and mortality data for the years 1993, 1994, and 1995 from the various hospitals in Delhi under the Director General of Health Services, Delhi.