STATE OF HEALTHCARE IN INDIA

A good healthcare is one of the crucial element for country like India which aspire to become a global power. However a close assessment on access, quality, spending and other factors shows a wide variation. Yet from past few years there is buzz in political corridor for universal health coverage and increase the public spending on healthcare which is dismally low to 1% of GDP. 

What does universal healthcare mean ? 

According to WHO - Universal coverage (UC), or universal health coverage (UHC), is defined as ensuring that all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.

It encompasses

1) Equity in access to healthcare.

2) Quality of health service is good enough.

3) Financial risk protection.

STATE OF HEALTHCARE 

Today, most of the healthcare is provided by private sector which is very costly and unregulated. Public healthcare is also provided by government but they lack in funding as well as there is a issue of negligence from doctor and other staffs. Out of total spending 70% is out of pocket spending which is one of the highest in developing country.

There are two flagship government scheme on healthcare. One of that is National Health Mission (NHM) and other is Rashtriya Swasth Bima Yojana (RSBY). 

NHM works on decentralised planning for implementation of program right from the village level to block and so on to national level (have involvement of panchayati raj institution and local community). It has lead a unique initiative of community based volunteer called Accredited social health activist (ASHA) which have a strong presence in rural areas and shown positive result in health indicators like lowering of infant mortality rate, lowering of maternal mortality rate etcetera. 

The most unfortunate part of this project is that it has met the same fate as other government projects that is corruption. There is huge corruption prevailing in its program. One of the sub project under this named as Janani suraksha yojana in which money is dispensed out by the doctors by registering fake child birth.

RSBY was introduced by labour ministry as  a insurance scheme for the below poverty line  families . It gives insurance of Rs 30,000/- per year for most of the disease that require hospitalisation. This program has proved a panacea for poor people. But this program only covers benefit of secondary care. The shortfall of this program is, it is not integrated with primary care which if otherwise done would help in releasing significant pressure from secondary care.

The way to solve out these problem is centre and state should spend more on health with a vision. Flexible new                                                          mechanism should be rolled out for efficient implementation of programs. 

Learning by doing is only way forward.

EXPECTATION FROM BUDGET 2015-16

The most awaited full fledged budget of NDA government will kick off from February 23. This budget is important from the  viewpoint of new political regime that have received a massive electoral victory in general election of 2014. People of India across every social strata have very high hope and expectation from the government on economic platform.
However what is most important point to observe here is, it will be a showcase of Narendra modi vision with Arun Jaitely presenting finance budget and Sadanand Gowda presenting railway budget.


 The budget will be presented at time when GDP growth has picked up and retail inflation is lowest in last 5 years. At the same time whole world has slipped into slow economic depression impacting demand of goods and services. However what  matters most to country like India is steep fall in crude oil prices to below $50 per barrel.

EXPECTATION ON REFORMS

 The government seemed very serious in reforms in industry by "MAKE IN INDIA" programme and changing the way the subsidies are distributed. In initial stages it has shown a good trend but  it have to go miles in correcting all these things. Government is showing keen interest in GOODS AND SERVICES TAX and may push this bill in current upcoming session.


The issue to worry is cut in social sector expenditure across various schemes such as ICDS, MID DAY MEAL, FOOD SECURITY ACT, MGNREGA etcetera. From the past records of government there might be cut in health , education sector and subsidies as well.

The logic behind slashing subsidies and social sector expenditure is that most of the part goes to undeserved people. The solution to this problem is revamping the system through these services are delivered and this may be done by clean and efficient third tier of government. India should take forward the issue of co operative federalism and make it happen.

The government should focus on increasing capital expenditure i.e. to build road, railways, power plants etcetera so that in short term it generate employment in infrastructure sector and in long term it start yielding to boom the economy. To increase capital expenditure government should focus on the revenue foregone in the form various tax incentives.

Another issue that is very important here is to  revive investment cycle that has slowed down in past decade. For that to happen overall confidence in investor has to be enhanced by removing the bottleneck of slow clearances of files.