Inequity & Private Healthcare

NEWS HIGHLIGHT

Theme : Health & Education
Paper:GS - 2

 India’s public expenditure on health now stands at 1.28 per cent of the GDP but even then, it is way lower than the average expenditure by countries clubbed as among the "poorest".

TABLE OF CONTENT

1. Context
2. Public Health
3. Private Sector in Healthcare
4. How to make Private Sector more Affordable & Qualitative
5. Initiatives taken for Healthcare
6. Global Practices : Canada
7. Major Challenges with the Healthcare System
8. Road Ahead

Context : India’s public expenditure on health now stands at 1.28 per cent of the GDP but even then, it is way lower than the average expenditure by countries clubbed as among the "poorest".

Public Health : 

It is the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.

Private Sector in Healthcare : 

• Private spending constitutes nearly 60% of overall expenditure on health.
• The private sector in India is dispersed: Marked inequities between rural and urban areas and widespread market failure.
• The income disparities, backwardness, and under-regulation incentivises the private sector to differentiate into a host of organizations, each serving its own customer base.

How to make Private Sector more Affordable & Qualitative

• Encompass a wide range of policy instruments that alter the operating conditions of the private sector.Such policies have to be enshrined in our national health policy.
• Need of overarching policies that drive down private healthcare costs even for the self-paying consumer with little or no government subsidy.
• Incentivising and propagating Business process innovations (BPI): such as the cost-reducing innovations by Aravind Eye Clinic and Narayana Hrudayalaya.
• Creating affordable and effective private health insurance products is another important option.
• Task shifting in healthcare is an evidence-backed instrument to hold down costs, especially in under-resourced settings.The National Commission for Allied and Healthcare Professions Act, 2021 can be a boost in this direction.

Initiatives taken for Healthcare : 

• National Health Mission
• Ayushman Bharat.
• Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
• National Medical Commission
• PM National Dialysis Programme.
• Janani Shishu Suraksha Karyakram (JSSK).
• Rashtriya Bal Swasthya Karyakram (RBSK).

Global Practices : Canada

• Canada has conceived regional health boards: They organize care equitably within regions, exploit economies of scale, and bring down healthcare costs.
• Boards have adequate representation from communities and enough power to determine:
• Local policy and resource allocation
• Impose caps on the maximum number of healthcare providers
• Build working networks of care.

Major Challenges with the Healthcare System : 

• Inadequate reach: The inadequate reach of basic healthcare services, shortage of medical personnel, quality assurance, the inadequate outlay for health, and most importantly insufficient impetus to research.
• Inadequate Fund: The inadequate fund allocation by the administrations is one of the grave concerns.
• Optimal Insurance: The concept of health insurance is still not clear in India and the market is still virgin.
• No focus on Preventive Care: In India, there is a very low emphasis on preventive care, which can be proved very effective in solving a lot of problems for the patient in terms of misery or financial losses.
• Less emphasis on Medical Research: In India, there is not much impetus being given to R&D and cutting-edge technology-led new initiatives. Such technologies could be useful in an unprecedented situation like Covid-19.
• Issue of Policy Making: For providing effective and efficient healthcare services policymaking is certainly an important aspect. In India, the problem is more fundamental of supply than demand, where policymaking can be effective.
• Shortage of Medical Workforce: In India, there is a shortage of doctors, nurses, and other staff in the health sector. As per a report laid down by a minister in Parliament, there is a shortage of 600,000 doctors in India.
• Lack of structure: Private hospitals are expensive and public hospitals are either not enough for the Indian Population or lack the basic facilities.

Road Ahead : 

• Health maintenance organizations (HMOs): Creating organized networks of providers like health maintenance organizations (HMOs), which can be regulated easily, has been envisioned in recent policy pronouncements.
• BPIs are confined to a few philanthropic organizations and find little mainstream policy or research attention.Healthcare ecosystem does not naturally incentivise: such innovations, regulatory and economic policy signals can be facilitative.
• Widening the ambit of practice of nurses and allied personnel with strong emphasis on health policy, along with concurrent mainstreaming of such practice roles across the private sector.
• Strong political will and the abrupt removal of unnecessary restrictions is needed to allay resistance.

FAQs : 

1. What are various Initiatives taken for the Healthcare Sector ?

ANS.  Initiatives taken for Healthcare : 

• National Health Mission
• Ayushman Bharat.
• Pradhan Mantri Jan Arogya Yojana (AB-PMJAY).
• National Medical Commission
• PM National Dialysis Programme.
• Janani Shishu Suraksha Karyakram (JSSK).
• Rashtriya Bal Swasthya Karyakram (RBSK).

2. What is Public Health ?

ANS. It is the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.