Context
The only sustainable solution is robust infrastructure and sufficient manpower, not controlling the prices of drugs
Author asks
Author presents us with following question at the start of the article itself and states that they need to be pondered upon before deciding any policy measure directed at health sector
Q: What do patients actually want? Will they settle for compromised, sub-standard healthcare as long as prices are affordable? Or does the vast majority prefer the best quality possible at rational cost?
Dramatic transition: What needs to be done?
Author states that India is witnessing a dramatic transition in disease burden, with non-communicable diseases taking centre stage.The only sustainable solution lies in
- Robust infrastructure
- Effective resource mobilization
- Capacity-building within our states
Author’s contention
Author contends that we need to improve the quality of doctors and nurses, healthcare delivery systems, better hygiene and sanitation levels, and not just focus on controlling the prices of drugs
Barriers to access
Author points out that the access to healthcare for India’s vast population remains an enormous challenge. The real barriers to access are
- Deficient infrastructure: A study by IMS Health found that, while a majority of our population resides in rural and tier-II/III/IV towns, healthcare infrastructure, including hospitals, hospital beds per patient, path labs, diagnostic centers and trained doctors, is severely limited. This needs to be addressed on an urgent basis
- Manpower constraints
Biggest issue: Low healthcare spending
The biggest issue is our low spending on healthcare. India stands right at the bottom of the list when it comes to budget allocation for healthcare
- A small health budget: In the World Health Statistics 2015, WHO ranked India 187th among 194 countries and yet our health budget is abysmally low. From being a meagre 0.9% of GDP (gross domestic product) in 2005, (according to the Economic Survey 2015-16), government expenditure (Central and state governments combined) on health as a percentage of GDP has gone up by a whisker to about 1.3% while other developing nations, such as Thailand and some African countries, spend over 5% of their GDP on health
Other problems
- Low health insurance coverage: The prevalence of health insurance coverage is very low in the country. The number covered under health insurance policies during the financial year 2015-16 was 358.9 million, which is approximately 30% of India’s population
- IRDA Obligations 2015:The Insurance Regulatory and Development Authority of India (IRDA) has notified IRDA (Rural and Social Sector) Obligations, 2015 that mandates for every insurance company to offer insurance coverage to the rural and defined social sector population. This is a step in the right direction
Some positives
Not all is lost, though. Some promising steps have been taken recently
- National Health Mission: Under the National Health Mission, support is being provided to states and union territories to strengthen their healthcare systems and provide accessible, affordable and quality healthcare to all citizens
- Universal Health Coverage: Universal health coverage wherein people will be able to access the quality health services that they need, without suffering financial hardship, is a key goal of the 12th Plan
Read More: Universal Health Coverage (UHC)
- Rashtriya SwasthyaBima Yojana (RSBY): The government of India has been implementing the Rashtriya SwasthyaBima Yojana (RSBY) since 2008
- Centrally Sponsored Scheme: This is a centrally sponsored health insurance scheme which covers our below poverty line population and 11 other defined categories (Mahatma Gandhi National Rural Employment Guarantee Scheme workers, construction workers, domestic workers, sanitation workers, mine workers, licensed railway porters, street vendors, beedi workers, rickshaw pullers, ragpickers and auto/taxi drivers) that are enrolled under the RSBY
- Health insurance:This population is entitled to cashless health insurance coverage of up to Rs30000 per annum per family
- Out-of-pocket expenditure, up to Rs30000 per family each year, is provided under the RSBY
Way forward
Author states that India needs a health policy which encompasses views from all the stake holders including patients & patient groups
