News Highlights:
- Universal Health Care is seen as a route to building robust, responsive and efficient health systems capable of addressing growing inequalities in healthcare demands along with shielding populations from spiralling healthcare and medicine costs.
- India has taken great leaps in the field of health care in recent times and has set for itself ambitious targets in the healthcare system.
Universal Health Care (UHC):
- About:
- The basic idea of UHC is that no one should be deprived of quality health care for the lack of ability to pay.
- UHC, in recent times, has become a critical indicator for human equity, security and dignity.
- UHC has become a well-accepted objective of public policy around the world.
- It has even been largely realised in many countries, not only the richer ones (except the US) but also a growing number of other countries such as Brazil, China, Sri Lanka and Thailand.
- The time has come for India (or some Indian States, at least) to take the plunge.
- Routes to Achieve UHC:
- UHC typically relies on one or both basic approaches: public service and social insurance. In the first approach, health care is provided as a free public service, like a fire brigade or public library.
- The second approach (social insurance) allows private as well as public provision of health care, but the costs are mostly borne by the social insurance fund(s), not the patient,
- Quite different from a private insurance market, it is the one where insurance is compulsory and universal, financed mainly from general taxation, and run by a single non-profit agency in the public interest.
- The basic principle is that everyone should be covered, and insurance should be geared to the public interest rather than private profit.
- Significance of UHC:
- Universal health coverage directly impacts a population’s health and welfare.
- Access and use of health services enable people to be more productive and active contributors to their families and communities.
- It also ensures that children can go to school and learn.
- At the same time, financial risk protection prevents people from being pushed into poverty when they have to pay for health services out of their own pockets.
- Universal health coverage is thus a critical component of sustainable development and poverty reduction and a vital element of any effort to reduce social inequities.
- Universal coverage is the hallmark of a government’s commitment to improving the well-being of all its citizens.
Challenges to UHC:
- Lack of Public Health Centres:
- Even in a system based on social insurance, public service plays an essential role.
- The absence of public health centres dedicated to primary health care and preventive work creates the risks of patients rushing to expensive hospitals every other day, thus making the whole system wasteful and expensive.
- Containing Costs:
- Containing costs is a major challenge with social insurance because patients and healthcare providers have a joint interest in expensive care, getting better healthcare for one and earning for the other.
- A possible remedy is to make the patient bear part of the costs, but that conflicts with the principle of UHC.
- Recent evidence suggests that even small co-payments often exclude many poor patients from quality health care.
- Identifying Services under UHC:
- Another big challenge remains in identifying what services are to be universally provided and what level of financial protection is considered acceptable.
- Offering the same services to the entire population is not economically feasible and demands massive resource mobilisation.
- Regulation of Private Sector:
- Another challenge with social insurance is to regulate private healthcare providers. A crucial distinction needs to be made between for-profit and nonprofit providers.
- Non-profit healthcare providers have done great work around the world
- For-profit healthcare, however, is deeply problematic because of the pervasive conflict between the profit motive and the patient’s well-being.
Recent Government Initiatives:
- National Health Policy (NHP):
- The National Health Policy (NHP) 2017 advocated allocating resources of up to two-thirds or more to primary care as it enunciated the goal of achieving “the highest possible level of good health and well-being, through a preventive and promotive healthcare orientation”.
- Pradhan Mantri Jan Arogya Yojana (PMJAY)
- A 167% increase in allocation this year for the Pradhan Mantri Jan Arogya Yojana (PMJAY) — the insurance programme which aims to cover 10 crore poor families for hospitalisation expenses of up to ₹5 lahks per family per annum.
- Incentivising private sector
- The government’s recent steps to incentivise the private sector to open hospitals in Tier II and Tier III cities.
- Health-insurance schemes.
- Individual states are adopting technology to support health-insurance schemes.
- For instance, Remedinet Technology (India’s first completely electronic cashless health insurance claims processing network) has been signed on as the technology partner for the Karnataka Government’s recently announced cashless health insurance schemes.
Pic Courtesy: Freepik
Content Source: The Hindu