ELECTORAL SEASON AND RESTRUCTURING THE HEALTH SYSTEM

THE CONTEXT: India’s healthcare system is in dire need of reform. The intersection of healthcare policy and politics in India reveals contrasting views among political parties. India needs substantial reforms and strategic investments to address the challenges within the healthcare infrastructure.

ABOUT UNIVERSAL HEALTH COVERAGE

Universal Health Coverage (UHC) aims to provide affordable and quality healthcare services to all individuals in India, regardless of their financial status. This requires comprehensive reforms and strategic investments to improve health infrastructure and remove financial barriers. UHC presents an opportunity to address systemic disparities and enhance healthcare delivery nationwide.

FEATURES OF UNIVERSAL HEALTH COVERAGE

• Financial Risk Protection: UHC aims to protect people from financial risks related to healthcare. In Rwanda, a community-based insurance scheme has reduced healthcare expenses, showcasing UHC’s potential for financial risk protection.
• Coverage of Essential Health Services: UHC encompasses a comprehensive package of services, from prevention and primary care to treatment, rehabilitation, and palliative care. The UK’s National Health Service (NHS) provides a broad spectrum of healthcare services free at delivery, funded through taxation.
• Resilient Healthcare Systems: Improving healthcare infrastructure is crucial for universal health coverage and sustainability. Japan’s system, which offers universal coverage and emphasizes preventive care, shows how investments aid UHC goals.
• Inclusion of Vulnerable Populations: UHC schemes aim to provide healthcare access to marginalized populations. India’s Ayushman Bharat scheme targets over 500 million vulnerable individuals and offers free secondary and tertiary care health insurance.

ISSUES

• Differential Health Policies Among Political Parties: Political parties have varying views on health care, with differing opinions on whether health is a public good or a commodity, as reflected in party manifestos.
• Challenges in Achieving Universal Health Coverage (UHC): Achieving Universal Health Coverage (UHC) requires genuine reform, strategic restructuring, and efficient implementation at the grassroots level to effectively overcome challenges. For instance, India’s strategy for UHC involves purchasing healthcare services from the private sector on an inflationary fee-for-service model despite supply shortages of specialists and nurses.
• Flawed Policy Focus: The policy is misguided in prioritizing tertiary medical care while neglecting primary and secondary levels that could efficiently manage most ailments. This is an apparent misallocation of resources that needs immediate attention.
• Inadequate Health Infrastructure and Resources: The primary and secondary health infrastructure is weak, and there is a severe shortage of human resources. For instance, states like Bihar still have a critical shortage of doctors, which creates challenges in delivering quality healthcare services.
• Challenges in Health System Reformation: There is a need for substantial reforms in the healthcare system architecture. Although measures have been taken, they have been incremental and fail to address systemic dysfunction and distortions.
• Imbalance in Health Budget Allocations: Despite budget increases, public health spending as a proportion of GDP has remained relatively stagnant, underscoring an imbalance in budgetary allocations and the need for more strategic fiscal planning in the healthcare sector.

THE WAY FORWARD

• Strategic Healthcare Investments: The need for strategic investment in primary and secondary healthcare infrastructure is exemplified by Thailand’s successful implementation of Universal Health Coverage (UHC) in 2000, showcasing the impact of targeted investments in strengthening healthcare infrastructure.
• Comprehensive Healthcare Reforms: Establishing the National Medical Commission and expanding social health insurance under the National Democratic Alliance (NDA) are national examples of comprehensive reform initiatives, reflecting the need for overarching healthcare reform strategies to address systemic complexities.
• Patient Outcome-Based Health System: The need for a patient outcome-based health system establishes the importance of IT and monitoring systems to evaluate performance based on outcome data linked to financing, drawing from successful examples of reform processes executed in other countries.
• Investment in Healthcare Workforce: Turkey’s Health Transformation Program’s success in adding hospital beds and doubling the number of nurses and doctors underscores the importance of investing in the healthcare workforce and public health infrastructure, providing a model for strategic resource allocation and professional capacity building.
• Leveraging Technology for Monitoring and Evaluation: Technology integration for robust monitoring and evaluation of healthcare services aligns with successful examples from countries like Turkey, which enhanced its health infrastructure through strategic technology integration.
• Strategic Capacity Building through Training and Upskilling: Prioritizing the training and upskilling of healthcare staff at the grassroots level, as exemplified by Thailand’s deliberate capacity-building efforts, emphasizing the significance of the infusion of new organizational capacities and resources.

THE CONCLUSION:

India’s healthcare system has the potential to achieve equitable and impactful healthcare delivery if it implements necessary reforms, addresses disparities in healthcare spending, and learns from global examples.

UPSC PAST YEAR QUESTIONS:

Q. Appropriate local community-level healthcare intervention is a prerequisite to achieving ‘Health for All ‘in India. Explain. (2018)

Q. The public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest? (2015)

MAINS PRACTICE QUESTION:

Q. Examine the current challenges facing the healthcare infrastructure in India and propose a comprehensive strategy for reform. How can strategic investments and successful international healthcare models be utilized to address critical issues and bolster the healthcare system in the country?

SOURCE: https://www.thehindu.com/opinion/lead/electoral-season-and-restructuring-the-health-system/article67871820.ece