Past experience suggests that these efforts must be carefully monitored to ensure that the poorer among the insured are able to access scheme benefits, and that the quality and quantity of health care provided has to be monitored and regulated. In particular, there needs to be further discussion and debate as to whether or not it is a good idea to use public funding to improve financial access to private hospitals (as is occurring under the RSBY). In the absence of systems for monitoring and regulating private hospitals, such schemes risk exposing poor people to care that is unnecessary, of poor quality, or unneces- sarily expensive. A study by Ranson and John (2001) docu- mented the problem of unnecessary hysterectomies, often of poor quality, performed on members of a community-based health insurance scheme.