India’s Health Policies Need Better Primary Care

Source: The post India’s Health Policies Need Better Primary Care has been created, based on the article “From insurance-driven private health care to equity” published in “The Hindu” on 17th March 2025. India’s Health Policies Need Better Primary Care.

UPSC Syllabus Topic: GS Paper2- Governance-Issues relating to development and management of Social Sector/Services relating to Health

Context: The article discusses India’s health policies and budget. It highlights how Ayushman Bharat focuses on hospital care but neglects primary health care. It warns against over-reliance on private insurance and suggests investing in community health services to reduce costs and improve accessibility.

For detailed information on Public Health Sector read this article here

How does Ayushman Bharat impact health care in India?

1. Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) helps reduce out-of-pocket expenditure (OOPE) by covering hospitalisation, surgeries, and procedures.
2. However, it focuses on tertiary care while neglecting primary health care (PHC), which is essential for cost-effective health care.
3. PHC reduces long-term costs and prevents diseases, but AB-PMJAY shifts attention away from preventive and community-based health care, increasing reliance on private hospitals.
4. This contradicts the Bhore Committee’s vision of a pyramid-shaped health system, with PHC as the foundation tapering to secondary and tertiary care.

How is the health budget allocated, and what are its challenges?

1. The 2025 Budget allocates ₹9,406 crore to AB-PMJAY, which is ₹2,000 crore more than the previous year.
2. The total health budget includes ₹95,957.87 crore for the Department of Health and Family Welfare and ₹3,900.69 crore for the Department of Health Research.
3. The National Health Mission (NHM), which supports grassroot health care, receives a declining share, indicating the government’s reduced focus on universal health care.
4. The Budget prioritises medical digital infrastructure and medical education expansion rather than strengthening primary health care.

How does the increase in foreign direct investment (FDI) affect health care?

1. The government increased the FDI cap in the insurance sector from 74% to 100%, following a previous increase from 49% to 74% in 2021.
2. The goal is to increase insurance penetration, especially in rural areas, and support the vision of “Insurance for All” by 2047.
3. The Insurance Regulatory and Development Authority of India (IRDAI) expects more capital and expanded coverage.
4. However, informal workers and marginalised urban populations may struggle with insurance literacy and access to insurance benefits.
5. Without strict regulations, private insurance could lead to rising OOPE due to inflated medical costs and uncovered consumables.

What are the risks of relying on private insurance for health care?

1. The U.S. model of private insurance-driven health care has led to high treatment costs, inequalities, and limited access for uninsured individuals.
2. Claim denials and corporate control over health care have sparked public criticism.
3. India risks similar issues if it relies too much on private insurance without strong government oversight.
4. ASHA workers and grassroots health-care providers may not receive sufficient coverage under current insurance models.

What can India learn from global health care models?

1. Thailand provides universal health coverage using tax revenue and strong public health investments.
2. Costa Rica’s system mandates insurance (Caja Costarricense de Seguro Social) while prioritising PHC and community-based services.
3. These models show that public investment in PHC reduces long-term health costs and ensures better access to care.
4. India needs to reassess its priorities, ensuring health policies focus on preventive and community-based health care instead of tertiary private care.
5. The government must implement safeguards to prevent private insurance from inflating costs and ensure that UHC (Universal Health Coverage) remains a reality, not just a slogan.

Question for practice:

Examine how India’s reliance on private insurance impacts health care accessibility and affordability.