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Government must take measures to achieve the goal of universal healthcare

India can take a leaf or two out of Obamacare to undertake regulatory reforms in healthcare sector

Dr Dharminder Nagar, MD, Paras Healthcare
Dr Dharminder Nagar
6 min read Last Updated : Apr 12 2019 | 3:44 PM IST
Coming closely after the demonetization drive that has overwhelmed the citizens and the economy for the past two months, the budget 2017 is being awaited with bated breath. Expectations are high that the government would reward the common man with incentives and tax concessions to make up for the hardships suffered by them. In a nutshell, most analysts are expecting a ‘feel good’ budget to have a balm-like effect on the country.

However, when it comes to healthcare, we need much more than feel-good announcements. Concrete well thought out long term measures are the need of the time to boost and further the government’s agenda of ensuring universal healthcare. In this context it would be good to briefly revisit the noticeable aspects of last year’s budget.  In the budget 2016, the government tried to improve thrust on two major A’s in healthcare - affordability and accessibility - with special focus on the elderly and poor families. The announcement to open 3,500 generic medical stores and the National Dialysis Program were important moves that laid out the government’s vision for increasing the reach of public healthcare. Another dimension to the same goal was the announcement of a basic insurance cover.

Given the positive vibes sent by the budget 2016, the healthcare sector expects more substantial long-term measures this time, laying out a concrete long term plan towards the goal of healthcare for all. This must also include rise in healthcare spending.  Here is a list of goals we expect would be furthered through this budget.

Increase healthcare spending
Poor spending on healthcare has been a major concern in India, a country where majority of people cannot afford private healthcare facilities. When it comes to public expenditure of healthcare in proportion to GDP, India ranks abysmally low; much below other BRICS countries. This makes ‘Health for All' a distant dream. In this context, the objective laid out in the National Health Policy to increase healthcare expenditure from 1.04 per cent of GDP to 2.5 per cent by 2020, with 70 per cent of this being dedicated to primary health care, has been a welcome step. 

There has, however, been no forward movement yet towards achieving this goal. Unfortunately, governments in India have traditionally considered healthcare allocation as ‘spending’, rather than as an ‘investment’. Truth is that increasing social spending including on healthcare brings about major developmental and growth benefits for the economy.

Improving access and infrastructure in rural areas
The dismal state of rural healthcare in our country is no secret. According to Statistics of the Ministry of Health & Family Welfare, in 2014-15 Primary Health Centres (PHCs) suffered from a shortfall of allopathic doctors to the tune of 11.9%. Besides, around eight per cent of the PHCs across rural India were running without a doctor whereas there was a shortfall of 81.2% specialists at the Community Health Centres (CHCs). 

Availability of healthcare facilities are also heavily skewed in favor of urban centres even as millions of people in rural areas do not have access to a qualified doctor. In such circumstances, improving access to healthcare facilities in rural areas remains a prime objective for India. Setting up of a few medical colleges in rural areas (as against urban areas which is currently the norm), may help improve doctor patient ratio in rural districts. We also expect announcements of incentives to doctors – both public and private to encourage them to practice in rural areas. The government can encourage private players to set up hospitals in rural areas by offering tax incentives and rebates as also infrastructural support. 

Launch concrete PPPs
In a country of over 1 billion people, it is practically impossible for the government to provide healthcare to all people. The private sector today plays a leading role in meeting the healthcare requirements of the country. The goal of universal healthcare can therefore be achieved faster and more comprehensively if the public and private sectors launch long-term partnerships with a vision to reach the last citizen. We expect the government to make some concrete announcements on PPPs to help improve access and affordability. The PPPs may promote better resource sharing between the two sectors and better coordination in providing for the poor. 

More public cancer treatment centres
Dr Dharminder Nagar, MD & CEO, Paras Healthcare
Increasing incidence of cancers is a rising concern in India with rise in cases being reported both from rural as well as urban areas. However, there has not been any major policy related change to address this rising burden. Unfortunately, despite several cancers being treatable today, a large number of people in India die because they are unable to afford comprehensive cancer treatment. A number of families go bankrupt seeking treatment for their loved ones. The government must set up dedicated cancer treatment centres in multiple cities and towns to help poor people avail of treatment.

Regulatory reform on the lines of Obamacare
The healthcare sector in India also needs major reform and regulation. This is where the Indian government can take a leaf or two out of Obamacare touted as one of the most significant achievements of the outgoing US President. Setting up a health insurance marketplace where Indians can purchase regulated and subsidised healthcare can allow millions have better access to health facilities.

Address need for more emergency medicine professionals
Emergency medicine is an emerging specialty in Indian medical sector and more and more hospitals today are setting up dedicated emergency departments. This is a positive development as dedicated focus on emergency and trauma medicine will help save millions of lives that are lost due to accidents and other emergency situations such as cardiac arrests. However, shortage of trained emergency staffers including paramedics and nurses has been a serious concern. 

We expect the government to take note of this situation and announce some education policy measures to churn out more medical emergency professionals. This can be done by adding seats for this specialty in all medical colleges or announcing dedicated institutions to train more EMT personnel.
Dr Dharminder Nagar is the managing director & CEO of Paras Healthcare
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