Ensuring healthcare for all citizens

By Dr. Naresh Trehan

India enjoys a one-time demographic dividend of a young and growing workforce, which is expected to fuel its growth well into the future. However, this can only be leveraged if our young people are healthy and productive. Healthcare is a concern for all citizens and universal access, financial assistance and good facilities are what Indians need when illness strikes.

India comes in at 131st rank in the Human Development Index (HDI). Equally, the global gender gap report places Indian women at 141 rank of 144 countries in its health and survival index. Almost one-third of the Indians do not have access to primary healthcare facilities and about 63 million fall back into poverty due to spending on illnesses. Non-communicable diseases, malnutrition and lack of timely and affordable healthcare are the key issues to be addressed in the Budget which should set a target of reaching 50 in the HDI in a specified period.

National Health Policy

The National Health Policy, brought out in 2017, promises to raise the level of public expenditure in the sector from the current 1.5% to 2.5% over three years, and we expect that the Budget would take a strong step towards this. The policy aims to provide free primary care and all public hospitals would ensure free drugs, diagnostics and emergency care services. The Budget could announce the establishment of public clinics and tertiary care hospitals to be set up within the next few years in all districts as also towns over a certain population size. Health insurance currently covers about a sixth of the population. It is important to raise this level to about 60%, when the focus would shift to prevention and targeted outcomes. Schemes by public sector insurance companies should be offered to low-income households at varying subsidies to provide assistance for illnesses.

The lack of doctors and nursing staff is another challenge. As per estimates, the workforce requirement in the healthcare sector is expected to go up from 4.7 million in 2017 to 7.3 million in 2022. More teaching hospitals are required with seats for specialisation at the post-graduation level. Land should be identified for specialty hospitals in small towns under the Smart Cities and AMRUT schemes. In particular, the 15 AIIMS-like hospital institutions should be quickly set up as announced. While public spending on healthcare must increase over the next few years, it is also important to encourage private sector participation. The private sector accounts for a major chunk of household spending and plays a key role in pharmaceuticals, R&D, diagnostic services and medical devices production. Infrastructure status to the healthcare sector could encourage more specialty and super specialty hospitals to comes up. NITI Aayog is working on an innovative strategy of public-private partnerships in three non-communicable diseases of cardiology, pulmonology and oncology. State governments are being encouraged to set up joint ventures with private sector institutions to provide services at certain district hospitals. This could be extended to more illnesses, with Budgetary support. India’s health outcomes will determine the trajectory of its future growth. The government must accord high priority to preventive and curative programmes and ensure universal access to medical facilities in the shortest time.

(The writer is chairman, CII Healthcare Council and CMD, Medanta – The Medicity)

Source: The Hindu


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