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.
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