Stronger public healthcare system needed in India

Namrata Devikar
Sunday, 11 February 2018

After demonetisation, the ‘poor and vulnerable families’ in the country suffered the worst as many of them were depending on cash. Media, during this time, also highlighted how the majority of the population was adversely affected due to a severe cash crunch.

But now the supposed ‘Ache din’ are finally here as the government has again put the healthcare of the ‘poor and vulnerable families’ on its priority list in the 2018-2019 health budget allocation.

After demonetisation, the ‘poor and vulnerable families’ in the country suffered the worst as many of them were depending on cash. Media, during this time, also highlighted how the majority of the population was adversely affected due to a severe cash crunch.

But now the supposed ‘Ache din’ are finally here as the government has again put the healthcare of the ‘poor and vulnerable families’ on its priority list in the 2018-2019 health budget allocation.

Of course, this is the last full term budget for the BJP ahead of the 2019 election. And in a bid to make their vote banks happier, they have, yet again made a short-sighted promise compromising the greater good.

After the budget, center’s ambitious National Health Protection Scheme (NHPS) for the ‘poor and vulnerable families’ was the talk of the town. Though the highlights spoke about the pro-poor stance of the government, the overall allocation said otherwise.

Pro-poor budget?
Experts from the city highlight that the union government’s flagship program, National Health Mission (NHM) was given Rs 700 crore fewer funds as compared to last year. The government website of NHM states NHM encompasses its two sub-missions, the National Rural Health Mission (NRHM) and the newly launched National Urban Health Mission (NUHM).

The main programmatic components include health system strengthening in rural and urban areas- reproductive, maternal, neonatal child and adolescent health and communicable and non-communicable diseases. The NHM envisages achievement of universal access to equitable, affordable and quality health care services that are accountable and responsive to people’s needs.

Speaking about the recent budget allocation, Dr Abhijeet More, a public health expert from the city said that the overall budget allocation for the National Health Mission (NHM) has been reduced by Rs 700 crore as compared to last year.

“This reduction in allocation will clearly hamper many sub-programs under this flagship which has a wide reach in every state. The program Reproductive Health Care (RHC) budget for this has been reduced by Rs 1,200 crore as compared to last year. Under this various initiatives of maternal and child health are functional currently,” said More.

Keeping these allocations aside, the popularized NHPS by the government will need at least this year to actually implement the policy. However, if implemented as said, it will increase the overall public health cost opined experts.

Speaking to Sakal Times, Economist HS Hari from Gokhale Institute of Politics and Economics (GIPE) said that the current system of insurance would involve private parties which would increase the cost of healthcare.

“To ensure better health facilities, strengthening the public system can be a good initiative but being dependent on an insurance policy can make the entire health care system expensive and go against the poor and vulnerable families,” said Hari.

He also highlighted that the implementation of the insurance is based on the assumption that the 60 percent expenditure burden will be borne by the center and 40 percent by the state. “But the states are already burdened with other initiatives so they cannot spare the money for the insurance policy,” said Hari.

Moreover, this insurance is only for the secondary and tertiary healthcare of the families. Experts noted that many families are often pushed below the poverty line after one of the member’s suffers a major ailment

On similar lines, Hari also underlined that strengthening of insurance policy would take Indian healthcare system the path of United States of America (USA) where the health care system is unaffordable to many.

What Indian today needs is a strong public healthcare system which supports the growing non-communicable diseases burden in the country. Also, a system which can give affordable healthcare to everyone equally. The ambitions of the government are to be applauded, however, their focus has certainly been on the wrong front. If the government aims to come to power again, neglecting affordable, public healthcare system would not be beneficial to the coming generation.

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