Mains Paper 2 : Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Prelims level: not much
Mains level: 2015 question: Public health system has limitations in providing universal health coverage. Do you think that the private sector could help in bridging the gap? What other viable alternatives would you suggest?
- Seven-year-old girl, Aadya, lost her life due to dengue-related complications in Fortis Hospital Gurugram last month.
- Root cause: the government has increasingly ceded space to the private sector in matters related to health.
- Despite, the article 47 mandating the improvement of public health as among the primary duties of government.
Growth of Private Sector
- Result of the government’s failure to provide affordable, accessible and equitable healthcare.
- Widened demand-supply gap and government’s inability to provide quality health care.
- 2007 paper in the EPW :“high absenteeism, low quality in clinical care, low satisfaction levels with care and rampant corruption plague the system.”
- High Level Expert Group formed by Planning Commission: “From 8 percent in 1947, the private sector now accounts for 93 per cent of all hospitals.
Attempts at Regulation
- The Clinical Establishments (Registration and Regulation) Act, 2010, model legislation for hospitals regulation by state governments has had a low uptake.
- Standard Treatment Guidelines for specific conditions and diseases not taken seriously.
- The West Bengal Clinical Establishments (Registration, Regulation and Transparency) Act, 2017, and the Karnataka Private Medical Establishments (Amendment) Bill, 2017 have been criticised as draconian.
- Insurance companies could work as a de facto check on false billing. But health insurance has penetrated only 3-4 per cent of the country’s population.
National Health Policy 2017
- Lays out a roadmap for public-private partnerships in healthcare.
- Recognises primary care will forever be in the domain of the government
- Talks of “strategic purchasing” of secondary and tertiary care from the private sector.
- For success of public-private partnership in healthcare, either the private sector should raise its trust quotient or
- the government should devise an effective regulatory mechanism to drill transparency into the private healthcare system.