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EDITORIAL ANALYSIS : Alleviating the scourge of private healthcare


Source: The Hindu

  • Prelims: Current events of national importance, health maintenance organizations (HMOs), GDP, National Commission for Allied and Healthcare Professions Act, 2021 etc
  • Mains GS Paper I & II: Development and management of social sectors/services related to Health and education etc


  • India’s Public health expenditure as a percentage of its GDP (28(one point two eight)%) and share of general government expenditure dedicated to health (4.8(four point eight)%) remain akin to the poorest countries.




Public Health:

  • It is the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.


Private sector in Healthcare:

  • Private spending constitutes nearly 60% of overall expenditure on health.
  • The private sector in India is dispersed: Marked inequities between rural and urban areas and widespread market failure.
  • The income disparities, backwardness, and under-regulation incentivises the private sector to differentiate into a host of organizations, each serving its own customer base.


How to make private healthcare more affordable without affecting care quality?

  • Encompass a wide range of policy instruments that alter the operating conditions of the private sector.
    • Such policies have to be enshrined in our national health policy.
  • Need of overarching policies that drive down private healthcare costs even for the self-paying consumer with little or no government subsidy.
  • Incentivising and propagating business process innovations (BPI): such as the cost-reducing innovations by Aravind Eye Clinic and Narayana Hrudayalaya.
  • Creating affordable and effective private health insurance products is another important option.
  • Task shifting in healthcare is an evidence-backed instrument to hold down costs, especially in under-resourced settings.
    • The National Commission for Allied and Healthcare Professions Act, 2021 can be a boost in this direction.


Global practice(Canada)

  • Canada has conceived regional health boards: They organize care equitably within regions, exploit economies of scale, and bring down healthcare costs.
  • Boards have adequate representation from communities and enough power to determine:
    • Local policy and resource allocation
    • Impose caps on the maximum number of healthcare providers
    • Build working networks of care.


Issues with healthcare system:


Initiatives for the Health Care Sector:

  • National Health Mission
  • Ayushman Bharat.
  • Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
  • National Medical Commission
  • PM National Dialysis Programme.
  • Janani Shishu Suraksha Karyakram (JSSK).
  • Rashtriya Bal Swasthya Karyakram (RBSK).


Way Forward

  • Health maintenance organizations (HMOs): Creating organized networks of providers like health maintenance organizations (HMOs), which can be regulated easily, has been envisioned in recent policy pronouncements.
  • BPIs are confined to a few philanthropic organizations and find little mainstream policy or research attention.
    • Healthcare ecosystem does not naturally incentivise: such innovations, regulatory and economic policy signals can be facilitative.
  • Widening the ambit of practice of nurses and allied personnel with strong emphasis on health policy, along with concurrent mainstreaming of such practice roles across the private sector.
  • Strong political will and the abrupt removal of unnecessary restrictions is needed to allay resistance.
  • Multiple steps to reduce entry barriers in medical education have been taken lately, medical education costs have sharply increased over the past decade or so.
    • This warrants policy attention.
  • Affordable private healthcare must only come to supplement strong public healthcare, while in turn having a complementary effect in enhancing the efficiency of government health spending.



Q. Besides being a moral imperative of the Welfare State, primary health structure is a necessary precondition for sustainable development.” Analyze.(UPSC 2021) (200 WORDS, 10 MARKS)


December 2022

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