The primary anchor of a health-care road map

The primary anchor of a health-care road map

Article:

1. Meenakshi Datta Ghosh has talked about strengthening the Governance to support the objectives of Ayushman Bharat Scheme.

Important Analysis:

2. Indian Prime Minister has launched the world’s largest health insurance scheme to provide universal health coverage.
3. The objectives of the Scheme will be implemented with the launch of two pillars of Pradhan Mantri Jan Arogya Yojana (PMJAY).

• Ayushman Bharat: Where 1.5 lakh health sub-centers are being converted into health and wellness centers to provide basic medical services.
• National Health Protection Mission (NHPM): Aims to provide health cover of ₹5 lakhs per family, per annum, reaching out to 500 million people.

4. Why we needed Ayushman Bharat:

• National Sample Survey Organization (NSSO) revealed that 85.9 percent of rural households and 82 percent of urban households have no access to healthcare insurance
• More than 24 percent households in rural and 18 percent in Urban India have met healthcare expenses through borrowings.
• Recommendation of WHO to spend at least 4% of GDP on healthcare.
• Rising incidence of communicable and non-communicable diseases.
• Rural India accounted for 25 million of the 36 million households, which faced catastrophic health shocks, while urban India accounted for the remaining 11 million.

5. Catastrophic health shock is defined as something that leads to annual expenses greater than the annual per-capita consumption of a household
6. However, Author has raised the concern that even though the Government has rolled out the universal scheme, Good Governance must be aligned to achieve its objectives.
7. According to Author Characteristics of best health care system should ensure:

• Accessible to all at low cost
• Make health-care providers accountable for cost and quality.
• Achieve a reduction in disease burden
• Eliminate catastrophic health expenditures for the consumer.

Recommendation to improve Good Governance in Health Care System:

8. Beneficiary Entitlement Recognition:

• De-link entitlement recognition from the poverty line and align the income lines for health.
• The government could then proceed, to scale the health premium subsidy e.g. economically weaker sections (entitled to 75-90%), lower income (entitled to 50%), and middle income groups (entitled to 20%).

9. Improving Accountability

• NHPM is pushing for hospitalization at secondary- and tertiary-level private hospitals, while ignoring the need of primary care.
• Participating Private Providers should work on the principal of mission, not margin.
• Upgrading district hospitals to government medical colleges for more coverage.
• Teaching hospitals to enhance capacities at the district level.

10. Transform Primary Health Care

• Effort to modernize and transform the primary care space.
• Bring together all relevant intersectoral action linking health and development so as to universalize the availability of clean drinking water, sanitation, garbage disposal, waste management, food security, nutrition and vector control.
• Swachh Bharat programme must be incorporated in the PMJAY.
• A public education media campaign could highlight the merits of personal hygiene and healthy living.
• Kerala and Tamil Nadu have demonstrated that high-performing, primary health-care systems do address a majority of community/individual health needs.
• The health and wellness clinics must connect with early detection and treatment.

11. Benefits of Effective Primary Health Care System:

• Early detection of cancers, diabetes and chronic conditions, mostly needing long-term treatment and home care.
• Minimize the demand for hospitalization.
• Investment in primary care would very quickly reduce the overall cost of health care for the state and for the consumer.

12. Artificial Intelligence powered mobile applications will soon provide high-quality, low-cost, patient-centric, smart wellness solutions
13. Along with an attempt to provide universal coverage, technology and innovation could further reduce costs of healthcare system in India.