Health

KEY POINTS

·         Specialist health care – Secondary and Tertiary health care services.

Why more focus on Primary health care?

·         Primary health services need to be strong enough to reduce the need for advanced care.

·         Less attention for primary care could lead to an overloaded specialist care services.

·         The outpatient care accounts for the largest fraction of out-of-pocket expenditure (OOPE).

·         Given the highly-profitable medical advances in the specialist health care, the private sector hugely participated only in tertiary care sectors and ignored primary health services.

·         It is futile to expect private entities to assume a prominent role in primary-care provision, which is a much less rewarding enterprise than a tertiary care.

·         So, it is imperative for the public sector to focus more on primary care, but the consecutive governments focus more on secondary and tertiary health care.

·         For example, the current budget allocates a grossly inadequate sum for primary healthcare and comfortably leaves the rest to the willingness of private entities.

·         This in turn could disproportionately drain resources because, unlike a private insurance where an individual pays the premium, in government’s schemes, the government pays most of the money from the health budget.

Evaluation of existing schemes

·         The existing Rashtriya Swasthya Bima Yojana (RSBY) has largely failed not only in substantially improving access to health services for the poor but also in reducing OOPE.

·         This is because such schemes are directed to address in-patient care needs, leaving out-patient needs unattended.

Way forward

·         Publicly-funded health insurance through private hospitals is by itself no bad move.

·         It can significantly increase access to quality secondary and tertiary care and reduce the burden of hospital expenses.

·         However, as a means of achieving universal health protection, a strong primary care system is vital.

·         Strengthening Primary health services and public hospitals should be a proactive step in ensuring Universal Health protection.

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