HEALTH CARE IN INDIA

India has a multi -payer universal health care model that is paid for by a combination of public and government regulated (through the Insurance Regulatory and Development Authority) private health insurances along with the element of almost entirely tax-funded public hospitals.^[1] The public hospital system is essentially free for all Indian residents except for small, often symbolic co-payments in some services.

NATIONAL HEALTH POLICY

The National Health Policy was endorsed by the Parliament of India in 1983 and updated in 2002, and then again updated in 2017. The recent four main updates in 2017 mention the need to focus on the growing burden of non-communicable diseases, the emergence of the robust healthcare industry, growing incidences of unsustainable expenditure due to healthcare costs, and rising economic growth enabling enhanced fiscal capacity.^[3] Furthermore, in the long-term, the policy aims to set up India’s goal to reform its current system to achieve universal health care.^[4]

In practice however, the private healthcare sector is responsible for the majority of healthcare in India, and a lot of healthcare expenses are paid directly out of pocket by patients and their families, rather than through health insurance due to incomplete coverage.^[5]

Government health policy has thus far largely encouraged private-sector expansion in conjunction with well designed but limited public health programs.

WHAT ARE THE CHALLENGES WITH THE HEALTH SECTOR ?

• Inadequate Access:
  • Inadequate access to basic healthcare services such as shortage of medical professionals, a lack of quality assurance, insufficient health spending, and, most significantly, insufficient research funding.
  • One of the major concerns is the administrations’ insufficient financial allocation.
• Low Budget:
  • India’s public expenditure on healthcare is only 2.1% of GDP in 2021-22 while Japan, Canada and France spend about 10% of their GDP on public healthcare.
    • Even neighboring countries like Bangladesh and Pakistan have over 3% of their GDP going towards the public healthcare system.
• Lack of Preventive Care:
  • Preventive care is undervalued in India, despite the fact that it has been shown to be quite beneficial in alleviating a variety of difficulties for patients in terms of unhappiness and financial losses.
• Lack of Medical Research:
  • In India, R&D and cutting-edge technology-led new projects receive little attention.
• Policymaking:
  • Policymaking is undoubtedly crucial in providing effective and efficient healthcare services. In India, the issue is one of supply rather than demand, and policymaking can help.
• Shortage in Professionals:
  • In India, there is a shortage of doctors, nurses, and other healthcare professionals.
  • According to a study presented in Parliament by a minister, India is short 600,000 doctors.
• Paucity of Resources:
  • Doctors work in extreme conditions ranging from overcrowded out-patient departments, inadequate staff, medicines and infrastructure.

WHAT IS THE POTENTIAL OF THE INDIAN HEALTH SECTOR ?

• India’s competitive advantage lies in its large pool of well-trained medical professionals. India is also cost competitive compared to its peers in Asia and western countries. The cost of surgery in India is about one-tenth of that in the US or Western Europe.
• India has all the essential ingredients for the exponential growth in this sector, including a large population, a robust pharma and medical supply chain, 750 million plus smartphone users, 3^rd largest start-up pool globally with easy access to VC (Venture Capital Fund) funding and innovative tech entrepreneurs looking to solve global healthcare problems.
• India will have about 50 clusters for faster clinical testing of medical devices to boost product development and innovation.
• The sector will be driven by life expectancy, shift in disease burden, changes in preferences, growing middle class, increase in health insurance, medical support, infrastructure development and policy support and incentives.
• As of 2021, the Indian healthcare sector is one of India’s largest employers as it employs a total of 4.7 million people. The sector has generated 2.7 million additional jobs in India between 2017-22 — over 500,000 new jobs per year.

INITIATIVES FOR THE HEALTH CARE SECTOR 

• 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).

WHAT SHOULD BE THE WAY FORWARD ?

• Improving Infrastructure and Human Resource: There is a need for investing in the construction of new healthcare facilities and upgrading existing ones, as well as increasing funding for healthcare services (currently 2.1% of GDP) and medical research.
  • Also, there is a need for increasing the number of healthcare workers. It includes increasing the number of medical schools and training programs, as well as offering financial incentives to encourage healthcare professionals to work in underserved areas.
• Accessibility of Quality Healthcare: There is a need for time bound implementing targeted programs to increase access to healthcare services for people living in poverty, members of lower castes, and specially women, as well as providing education and information about healthcare to these communities.
  • There is also a need for enforcing regulations, implementing quality control measures, increasing transparency and conducting audits of health care programs.
• Improving Mental Health Services: It includes increasing funding for mental health services, training healthcare workers to better address mental health issues, and reducing the social stigma associated with mental illness.
• Addressing the Root Causes of Health Inequities: The healthcare system should work in coordination with other sectors, such as education, housing and sanitation to address the social determinants of health and reduce overall health inequities.
• Sustainable Health Governance: This could include implementing better management systems, strengthening healthcare regulatory bodies and creating independent oversight mechanisms to ensure more effective and efficient healthcare services.
  • Also, suitable cybersecurity measures should also be taken to secure critical medical infrastructure and data from any cyber attack like recent Ransomware Attack on AIIMS Delhi.
• Tax Reductions: Incentivizing R&D (Research and Development) by additional tax deductions to further support greater investments in new drug developments and reducing GST (Goods and Services Tax) on life-saving and essential drugs is necessary.
• Towards One Health Approach: There is a need to recognize that the health of people is closely connected to the health of animals and our shared environment, and collective health initiatives covering healthy atmosphere, healthy animals, and healthy humans are the need of the hour.