A developing economy, India has a long way to go in terms of Universal Health Coverage and its implementation. The two main policies that aim to improve healthcare in India are the National Health Policy and the National Health Mission. The National Health Policy was approved by the Union Cabinet in 2017, and it seeks to improve the quality and accessibility in healthcare within set timelines. The policy proposes free diagnostics, free medicine, free emergency, and essential health care services in all public hospitals to ensure accessibility and affordability.
Earlier, the NRHM was launched to provide accessible, affordable and quality health care and insurance to the rural population. The NHP had proposed to direct about 70 percent of the health expenditure towards primary healthcare. There have been considerable developments in both policies, although some targets are yet to be met. National Health Protection Mission is another move that can bring about healthcare reform in India.
Challenges for India to Achieve UHC
Some of the challenges for India to achieve UHC include quality, infrastructure, accountability, efficiency, and skilled professionals. Seventy percent of healthcare is provided by the private sector in India and there exists a huge health disparity between classes, regions, urban and rural areas. To provide affordable healthcare to the marginalised, India has to implement its policies efficiently. Lack of accessibility and poor quality medical care has left many impoverished. Medical negligence, quacks, and traditional healers are impediments to quality healthcare in India. Lack of regulatory standards, stringent guidelines and poor implementation is a major challenge for Indian healthcare.
Preventive and promotive healthcare if implemented under UHC can help prevent diseases and lower healthcare costs. Mobile health clinics can ensure access to healthcare in remote areas. The country’s epidemiological spectrum is very vast and covering chronic illnesses, curative services, palliative care, mental health, etc can be challenging and a holistic system that is universally accessible is the need of the hour.
A conversation on UHC is crucial in India, a country that only spends 1.2-1.5 percent of its GDP on healthcare. According to the Ministry of Health, rolling out UHC will cost approximately 6.5 billion dollars per year for four years (2015-19). This is not exorbitant and is within the country’s means as the cost is just 0.28 percent of India’s GDP. At 61 percent, India has one of the highest out-of-pocket expenditure and over 63 million people are pushed to poverty every year due to rising healthcare costs. Insurance penetration is abysmally low and stands at 17 percent. Efficient implementation of the policies is the only way forward for UHC in India.