Why call for a comprehensive Public Health Act was much needed?

Context – India’s COVID-19 management explained by parliamentary panel and the key recommendation. 

What are the key findings of parliamentary standing committee? 

1. Low beds ratio– Before COVID-19 pandemic, the availability of government beds were terribly low in India. This amounts to 0.55 beds per 1000 population. 
2.  The burden of extending comprehensive healthcare has been borne by the Government hospitals as private hospitals were either “inaccessible or not affordable
3.  Low government spending – Public expenditure on health accounts for only 1.13% of the total health expenditure which is extremely low when compared to WHO recommendation of 5%. 
   1. Results in lack of infrastructure in public hospitals. 
4.  Insurance Regulatory and Development Authority of India (IRDAI) has capped the maximum age of entry for a standard policy at 65, which affects older citizen during such crises.  
5. Surge in insurance premiums up to 25 percent in the wake of the pandemic  

What are the recommendations of parliamentary committee? 

1. Need for a comprehensive Public Health Act – Taking note of complaints against private hospitals, it advocated the need for a “comprehensive Public Health Act” at national level with provisions to keep “checks and controls” over private hospitals.  
   1. The proposed Act should also keep a check on the black marketing of medicines and product standardization. 
2. The panel has called for an omnibus law that will curb profiteering during such crises and it can serve a larger purpose if it covered overall system reforms,  addressing misguided policies 
3. Cashless health insurance– The committee strongly recommends that the target should be to make COVID-19 treatment cashless for all people that are having insurance coverage. 

 However, the committee missed out on a few observations– 

• Surge in Insurance premiums- Insurance companies have raised the premium on health policies, especially for senior citizens, to even up to 25% of the insured value.  
• Moreover, insurance regulator, IRDAI, set 65 as the maximum age of entry for a standard policy earlier this year, affecting older uninsured citizens. 

What needs to be done? 

• Firstly, creating an equitable framework, with the government being the single and sole payer to care providers. With this, the government is able to resist commercial pressures in determining costs. 
• Secondly, the legal reform must provide for a time-bound transition to universal state-provided health services. 
• Lastly, there should be more investments in health infrastructure for the rapid scaling up of public health services.  The need to spend at least 2.5% of the GDP on health, the Indian government only spends about 1.3% of the GDP on the sector.