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

[op-ed snap] The Missing Healing Touchop-ed snap

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?

  1. Seven-year-old girl, Aadya, lost her life due to dengue-related complications in Fortis Hospital Gurugram last month.
  2. Root cause: the government has increasingly ceded space to the private sector in matters related to health.
  3. Despite, the article 47 mandating the improvement of public health as among the primary duties of government.
Growth of Private Sector
  1. Result of the government’s failure to provide affordable, accessible and equitable healthcare.
  2. Widened demand-supply gap and government’s inability to provide quality health care.
  3. 2007 paper in the EPW :“high absenteeism, low quality in clinical care, low satisfaction levels with care and rampant corruption plague the system.”
  4. 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
  1. The Clinical Establishments (Registration and Regulation) Act, 2010, model legislation for hospitals regulation by state governments has had a low uptake.
  2. Standard Treatment Guidelines for specific conditions and diseases not taken seriously.
  3. 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.
  4. 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
  1. Lays out a roadmap for public-private partnerships in healthcare.
  2. Recognises primary care will forever be in the domain of the government
  3. Talks of “strategic purchasing” of secondary and tertiary care from the private sector.
  1. For success of public-private partnership in healthcare, either the private sector should raise its trust quotient or
  2. the government should devise an effective regulatory mechanism to drill transparency into the private healthcare system.

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