News highlight:
India ranks poorly on multiple health financing indicators. Government should focus on making private healthcare affordable along with expanding public healthcare.
Key features of the Expert report:
- Public health expenditure:
- Its public health expenditure as a percentage of its GDP (1.28%) and share of general government expenditure dedicated to health (4.8%) remain akin to the poorest countries.
- Per capita health spending growth has not kept pace with rising incomes.
- Private spending still constitutes nearly 60% of overall expenditure on health.
- High healthcare costs remain limited to what the government can do to share the personal expenditure burden.
- It automatically becomes an issue of increasing government spending to reduce personal spending.
The scenario of the Healthcare Sector:
- About:
- Healthcare industry comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine, medical tourism, health insurance and medical equipment.
- India’s healthcare delivery system is categorised into two major components – public and private.
- The government (public healthcare system), comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of Primary Healthcare Centres (PHCs) in rural areas.
- The private sector provides a majority of secondary, tertiary, and quaternary care institutions with a major concentration in metros, tier-I and tier-II cities.
- Healthcare market:
- The Indian healthcare sector is expected to record a three-fold rise, growing at a CAGR (Compound Annual Growth Rate) of 22% between 2016–22 to reach USD 372 billion in 2022 from USD 110 billion in 2016.
- In the Economic Survey of 2022, India’s public expenditure on healthcare stood at 2.1% of GDP in 2021-22 against 1.8% in 2020-21 and 1.3% in 2019-20.
- In FY21, gross direct premium income underwritten by health insurance companies grew 13.3% YoY to Rs. 58,572.46 crores (USD 7.9 billion).
- The Indian medical tourism market was valued at USD 2.89 billion in 2020 and is expected to reach USD 13.42 billion by 2026.
- Telemedicine is also expected to reach USD 5.5 billion by 2025.
Challenges with the Health Sector:
- Lack of primary healthcare:
- Inadequate access to essential healthcare services, such as shortage of medical professionals, a lack of quality assurance, insufficient health spending, and, most significantly, insufficient research funding.
- One of the major concerns is the administration’s insufficient financial allocation.
- Low public expenditure:
- India’s public expenditure on healthcare is only 2.1% of GDP in 2021-22, while Japan, Canada and France spend about 10% of their GDP on public healthcare.
- Even neighbouring countries like Bangladesh and Pakistan have over 3% of their GDP going towards the public healthcare system.Lack of Preventive Care:
- Preventive care is undervalued in India, despite the fact that it has been shown to be quite beneficial in alleviating a variety of difficulties for patients in terms of unhappiness and financial losses
- Lack of Medical Research:
- In India, R&D and cutting-edge technology-led new projects receive little attention.
- Shortage in Professionals:
- There is a shortage of doctors, nurses, and other healthcare professionals in India.
- According to a study presented in Parliament by a minister, India is short 600,000 doctors
Steps To Be Taken:
- Enabling Preventive Care:
- In order to promote preventive care, the Union government has announced the conversion of primary health care centres into Health and Wellness Centers (HWCs).
- These HWCs will act as the pillar of preventive care and ‘gateway’ for access to secondary and tertiary health services.
- Thus, there is a need to accelerate the establishment of a network HWCs, for this extra funding through Corporate Social Responsibility (CSR) can be mobilised.
- Behavioural Change:
- There is a need to ensure people eat right, sleep right, maintain good hygiene, exercise, and adopt a healthy lifestyle that necessitates concerted interventions at various system levels.
- Cooperative Federalism:
- Given the major role that States have to play in creating strong health systems across the country, allocations provided by the Finance Commission can become the critical catalyst for transforming the nation’s health.
- State governments should be incentivised to invest in creating a dedicated cadre for public health at the state, district and block levels.
- Decentralisation:
- There is a need to make nutrition, water, sanitation and hygiene (WASH) part of the core functions of Panchayati raj institutions and municipalities.
- Creating a Nodal Health Agency:
- there is a need to create a designated and autonomous focal agency with the required capacities and linkages to perform the functions of disease surveillance, information gathering on the health impact of policies of key non-health departments, maintenance of national health statistics, enforcement of public health regulations, and dissemination of information to the public.
Pic Courtesy: The Hindu
Content Source: The Hindu