Pandemic resilience - Call for a Public Health Act

Why in news?

The recent report of the parliamentary Standing Committee on Home Affairs has called for a comprehensive Public Health Act.

What shortcomings did the pandemic expose?

• When the pandemic arrived, National Health Profile 2019 data showed that there were an estimated 0.55 government hospital beds for 1,000 people.
• Prolonged underinvestment in public health infrastructure thus left millions seeking help from a highly commercialised private sector.
• There was little regulatory oversight into this.
• Urban workers fled to their villages, afraid of the cost of falling sick in cities.
• The situation was even worse in rural areas, where care facilities are weaker.

What are the other concerns?

• India has committed itself to covenants such as the Sustainable Development Goals.
• But it continues to evade making the right to health a full legal and justiciable right under the National Health Policy.
• Oversight on hospitals to ensure that patients are not turned away in a crisis such as COVID-19 was missing.
• Among the committee’s observations is the absence of insurance cover for many.
• The panel is right to view this as a breach of trust.
• On the other hand, one of the pandemic’s impacts has been a rise in insurance premiums, especially for senior citizens, of even up to 25% of the insured value.
• The insurance regulator, IRDAI, even set 65 as the maximum age of entry for a standard policy earlier in 2020.
• This affected older uninsured citizens. Such age limits must be fully removed.

How will the Act benefit?

• The call for a Public Health Act comes as a response to the extreme stresses caused by COVID-19 as said above.
• Acknowledging the distortions, and the inadequacy of existing legal frameworks, the panel has called for a comprehensive law.
• It is a welcome call to reform a fragmented health system.
• The law is intended to curb profiteering during such crises and provide robust cashless health insurance.
  • The Act should also cover overall system reform, addressing the structural asymmetry created by misguided policies.
  • This would serve a larger purpose and address the commerce surrounding health-care provision.

What are the much needed reforms?

• The answer to creating an equitable framework for healthcare lies in a tax-funded system.
• The government must be the single and sole payer to care providers.
• This is a long-pending recommendation from the erstwhile Planning Commission, and should be part of any reform.
• The government, as the single-payer if not sole care provider at present, would be better able to resist commercial pressures in determining costs.
• This is equally applicable for central procurement of essential drugs, which can then be distributed free.
• Legal reform must provide for a time-bound transition to universal state-provided health services.
• It must work under a rights-based, non-exclusionary framework, with States implementing it.
• Private arrangements can be an option.
• COVID-19 has exposed the dangers of excessive reliance on private tertiary care.
• It highlights the need for raising public spending to the promised 2.5% of GDP on public facilities that are universally accessible.

Source: The Hindu