- 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
ARTICLE HIGHLIGHTS
- 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.
INSIGHTS ON THE ISSUE
Context
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.
QUESTION FOR PRACTICE
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)
