- Universal health coverage is getting prioritised as a part of political reform with the launch of two pillars.
Current state of Healthcare:
- Poor condition of healthcare in country; Lack of infrastructure;
- Poor health services in government hospitals; Private hospitals out of reach of most people.
- According to the Global Burden of Disease study, India is ranked low in the Healthcare index; India stands at a rank of 154.
- But despite this, the budget allotment on healthcare services is extremely low. India spends less than 2% of her GDP on public healthcare.
- The National Health Protection Mission or Ayushman Bharat Yojana, launched by the Government is the first major step.
- Ayushman Bharat Yojana is a program which aims to create a healthy, capable and content new India.
- It will also focus on the poor and weaker sections of the society.
- It aims to provide insurance of up to 5 lakh rupees to each family.
- The new scheme also intends to improve secondary and tertiary healthcare services for crores of Indians.
There are two flagship initiatives under Ayushman Bharat:
- Pradhan Mantri Jan Arogya Yojana (PMJAY):
- Under this scheme, 1.5 lakh health sub-centres are being converted into health and wellness centres.
- It will bring the healthcare system closer to the people.
- The centres will provide comprehensive healthcare, including treatment for non-communicable diseases and maternal and child health services.
- Besides this, they will also provide free essential drugs and diagnostic services;
- Rs. 1200 crore have been allocated for this flagship programme.
- The scheme will cover more than 10 crore poor families, which is approximately 50 crore persons.
- It will also setup wellness centres which will give poor people OPD facility near their homes.
- National Health Protection Scheme:
- The National Health Protection Scheme will cover over 10 crore poor and vulnerable families.
- It will provide coverage up to 5 lakh rupees per family, per year for secondary and tertiary care hospitalization.
Best health care at the lowest possible cost should be:
- make health-care providers accountable for cost and quality
- achieve a reduction in disease burden, and
- eliminate catastrophic health expenditures for the consumer.
Criticism of Ayushman Bharat:
- Currently, the NHPM is pushing for hospitalisation at secondary, and at tertiary-level private hospitals, while disregarding the need for eligible households to first access primary care, prior to becoming ‘a case for acute care’.
- It is important to note that without the stepping stone of primary health care, direct hospitalisation is a high-cost solution.
Problem of constraints:
- Public sector health capacities are constrained at all levels.
- Further, forward movement is feasible only through partnerships and coalitions with private sector providers.
- It is important to note that these partnerships are credible only if made accountable.
- It has been suggested that Health-care providers (public/private) should be accredited without any upper limit on the number of service providers in a given district.
Need of a holistic approach:
It is believed that one must bring together all relevant inter-sectoral action, linking health and development, so as to universalise the availability of:
- clean drinking water,
- garbage disposal,
- waste management,
- food security,
- nutrition and
- vector control.
Further, the Swachh Bharat programme must be incorporated in the PMJAY. These steps put together will reduce the disease burden.
- A public education media campaign could highlight the merits of personal hygiene and healthy living.
- The States of 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.
- It is believed that robust delivery of preventive, clinical and diagnostic health-care services will result in early detection of cancers, diabetes and chronic conditions, mostly needing long-term treatment and home care.
- This would further minimise the demand for hospitalisation.
- In conclusion, investment in primary care would very quickly reduce the overall cost of health care for the state and for the consumer. Technology and innovation are further reducing costs. AI-powered mobile applications will soon provide high-quality, low-cost, patient-centric, smart wellness solutions. Currently, the scaleable and inter-operable IT platform being readied for the Ayushman Bharat is encouraging.
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