The UHC is a long-term objective but the need of the hour is to create a roadmap for implementation, to establish checkpoints and to assign responsibilities of stakeholders
Universal health coverage (UHC) aims to achieve long-term healthcare goals for citizens in the country. However, the UHC is not a quick process and can be achieved in the coming years with adequate planning and support from all stakeholders. Universal healthcare is not only about achieving the numbers but also to ensure that minimum quality standards are met with. India has to battle simultaneously with both communicable and non-communicable diseases. Our aim should be to continue progress towards achieving both Millennium Development Goals and also arrest increase in diseases like cancer, diabetes, cardiovascular etc.
It is promising that the Government, through recently, announced the National Health Policy (NHP) 2017, which only emphasises on quality and affordable healthcare services to all but has also committed to spend more on public health, especially, for primary healthcare, which would help bridge demand-supply gap in rural areas.
The NHP’s main thrust is on UHC and affordable healthcare services for all without compromising on quality standards. Following focus areas of NHP 2017 should contribute towards ensuring: Universal, easily accessible, affordable primary healthcare; digital interventions for the nation's health; preventive and promotive focus with pluralistic choice; better regulatory mechanisms and quality control; fostering patient-focused, quality and assurance-based approach.
It is encouraging to note the focus on public-private collaboration. Since the private sector plays a major role in Indian healthcare, Public Private Partnership could be a critical enabler to ensure healthcare coverage across the length and breadth of the country and for all citizens of the nation. India's population is evolving and ageing with the geriatric age group expected to constitute 11 per cent share by 2025. Increasing urbanisation has led to an explosion of the non-communicable diseases and India now carries a dual burden of communicable and non-communicable diseases. According to a white paper, ‘Aarogya Bharat: India Healthcare Roadmap for 2025’, non communicable diseases will cost India $6.2 trillion by 2030. Hence, India's unique needs drive priorities for healthcare services and technologies.
India faces a severe shortage of both hard infrastructure and talent with rural-urban imbalances and variations in healthcare delivery. The strong bias towards curative care reflects a culture in which prevention and wellness receive only limited focus and investments in rural areas for primary care and public health have long been inadequate.
Apart from higher public spending in health infrastructure, the Government needs to promote universal access to essential healthcare for all with the provision being led by the private sector, and the Government shifting more towards a payer and regulator role with provision support focused on rural areas which are undeserved.
The UHC is a long-term objective but the urgent need is to create a roadmap for implementation, establish checkpoints and assign responsibilities among stakeholders. Also, its position on unifying existing public and social insurance schemes need to be clarified as India is moving towards universal health coverage. Regulatory ambiguity may significantly impede the ability to achieve some of the aspirations of the healthcare sector. The Government needs to take the lead in clarifying healthcare regulations for contracts among public and private players; for the management of health technology assessments; for price controls on essential healthcare services and so on.
The healthcare sector needs significant funding. It is a fact that the Government alone cannot meet the challenges. The Public Private Partnership is probably one of the best solutions. The Government can take care of primary and community health centers. Reforms and progress in health insurance will play a major role in accelerating the UHC. Maharashtra, Tamil Nadu, Karnataka, Rajasthan and Andhra Pradesh have had several successful projects. Other States can learn from them. The Maharashtra Government has outsourced diagnostic, screening and other services. The State's health department is opening up 31 computed tomography (CT) scan centres in several districts of the State on Public Private Partnership basis. For higher spending in healthcare sector, Public Private Partnership projects are required to be scaled up and implemented across the country and the Government needs to encourage successful projects.
(The writer is secretary general, NATHEAlTH)