How far the new, flag-ship initiative of the Government: Ayushman Bharat, can alter the health sector landscape in India? Analyse based on its significance and challenges.
Refer – The Hindu
IAS Parliament 7 years
KEY POINTS
Current situation of health sector in India
· Currently, Primary health centres in India are limited to only some elements of maternal and child care and control only few major infectious diseases.
· Public health action for preventive/promotive health has also been limited.
· There is a huge unmet need for primary health care, namely, care for non-communicable diseases, mental health, care of the aged, adolescent health, palliative health care, basic eye care and dental health.
· 80% of the Indian population is not covered under any health insurance scheme.
· Additionally, the cost of medi-care is very high in comparison with the average income of the population, which makes it unaffordable for many.
Ayushman Bharat has two dimensions:
1. It aims to roll out comprehensive primary health care with Health and Wellness Centres (HWCs) serving as the people-centric nuclei.
2. It aims to provide health cover of 5 lakh per family per year for hospitalisation in secondary and tertiary care facilities through NHPS.
· This will constitute the very foundation of New India’s health care system.
· But, Ayushman Bharat scheme is challenged in following ways:
Challenges posed by the Scheme
a) the funds allocated are grossly inadequate
b) overlap with many established State health insurance schemes
c) not covered outpatient care (responsible for 70% of people’s expenditure)
d) does not deal with preventive, promotive care
e) left out 80 crore (60% of the population)
Challenges posed by existing facilities
· Mismatched human resource policy – Successful HWCs require for a minimum number of regular salaried workforce with adequate training.
· But on the ground, governments have been reducing recruitment and contractualising the work force.
· Referral mechanism – This needs a well-coordinated referral mechanism with specialists in the secondary and tertiary hospitals, but there is very limited effort, investment going into this.
· Lack of service providers – Insurance does little for access to hospital care in vast areas where there are no providers. That needs public investment.
· Lack of regulation in private sector – In the absence of any effective regulation of the private sector, and given high levels of information asymmetry, the consumption of services is determined more by what private providers find more profitable to provide, rather than health-care needs of the poor.
