Health Sector – UHC, National Health Policy, Family Planning, Health Insurance, etc.

[op-ed snap] Is Ayushman Bharat a game changer?op-ed snap


Mains Paper 2: Governance | Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

From UPSC perspective, the following things are important:

Prelims level: Particulars of the scheme

Mains level: We have recently published some newscard on the same scheme. This is a comprehensive newscard on the health scheme. Complement it with our previously published newscards.


Health Sector: Challenges infront of India

  1. The country is having to confront the emerging problem of chronic non-communicable diseases such as cardiovascular diseases, diabetes, cancer
  2. Infectious diseases such as tuberculosis, malaria, dengue, H1N1 pandemic influenza and antimicrobial resistance remain a continued threat to health and economic security
  3. The health infrastructure is already under severe strain
  4. Out of pocket expenditure force families to sell their assets for getting required health services

National Health Protection Scheme (NHPS)

  1. The scheme was announced in the recent budget
  2. The scheme will provide Rs 5 lakh insurance cover per family per year
  3. The scheme is for secondary and tertiary healthcare, mainly for hospital care
  4. This flagship scheme is likely to benefit more than 37% of the population

Financial support

  1. The government will require Rs 12000 crore for it’s implementation, with cost shared on a 60:40 basis between central and state governments

Health and Wellness centres

  1. The finance ministry has also announced setting up or converting some 150,000 subcentres in the country into so-called “health & wellness” centres
  2. These centres will offer a set of services including maternal and child health services, mental health services, vaccinations against selected communicable diseases, and screening for hypertension, diabetes, and some cancers

The Ayushman Bharat programme: Two main aims

  1. To strengthen primary health care which has been lacking in the country and
  2. To offer finacial protection from catastrophic expenditure

How can the programme be a game changer?

  1. The scheme, if implemented properly could be a game changer by enhancing access to health care including early detection and treatment services by a large section of society who otherwise could not afford them
  2. Ultimately, NHPS could help country move towards universal health coverage and equitable access to healthcare which is one of the UN Sustainable Development Goals or SDGs

Not all issues will be solved with this scheme

  1. The NHPS scheme, which primarily offers support for clinical services such as hospitalization, is unlikely to help fix the broken public health system in the country
  2. Most primary health care centres suffer from perennial shortage of doctors and even district hospitals are without specialists
  3. Without addressing the human resouce situation, public sector health care will remain of poor quality and largely unacceptable, forcing patients to go to the private sector
  4. Therefore, it seems as if NHPS is likely to benefit private parties more than government health services

Suggestions for effective implementation

  1. For the success of the programme, effective implementation is the key
  2. For this an independent body or unit may be set up within the ministry of health & family welfare to plan
  3. This unit can help to plan, coordinate, and provide technical backstopping to states, including in capacity building and development of standards and guidelines for the programme
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