India’s Flawed Health Policy

Despite knowing that spending on health has a multiplier effect on its GDP, it is only over the last two years that the UPA-2 government spared a thought for the health of its population. Goaded on by the National Advisory Council (NAC), the government made grandiose announcements to provide relief to the common man’s health problems.

The idea of “Universal Health Care/Coverage” (UHC) as detailed in the 12th Plan made perfect sense. Adapted from an Expert Group recommendation, the vision is to ensure equitable access to all Indian citizens to affordable health services of assured quality.

UHC promised to take care of all the three major problems that impact the teeming masses that are the UPA’s vote bank – finding a good hospital, ensuring good investigations leading to accurate diagnosis and bearing the financial burden of healthcare.

Despite knowing that implementing UHC would have provided UPA with a strong electoral plank, it chose to shelve it. This is because the reality on the ground is very different. To find a good hospital, it needs to exist. We are all aware of the supply side constraints even in urban areas. Health penetration in India is estimated at 30% of its population.

Yet there is very little action from the government to build more facilities that will serve to diagnose and treat common ailments (primary care), offer advanced care such as hospitalization during pregnancy, accidents or epidemics (secondary care) and allow specialized treatment of conditions such as mental illness, heart conditions or diabetes (tertiary care).

To achieve this, the government would have to increase public spending in health to at least 2.5% of GDP from the current 0.9% (WHO recommends 5-6%). While public-private-partnerships (PPP) could have provided a well-intentioned start in the absence of immediate funds, the left-leaning NAC’s distrust of all things private led to its overruling the Planning Commission’s recommendations to this effect.

Unfortunately for its citizens, investing scarce resources into creating affordable world-class diagnostic and treatment facilities – all part of its grandiose announcements – has not been prioritized by the Government. Rather, by declaring health a state subject and pushing the onus onto state budgets, the UPA-led Government chose to free up and divert precious tax-payer money into ill-conceived centrally driven social welfare schemes that despite evidence of failure will continue to dole out munificence.

6 thoughts on “India’s Flawed Health Policy

  1. Good article Salil…. Healthcare costs needs to be shared between central and state bodies and for a country like India it should be minimum 6 to 7% to start with and it should reach at least 10% by next 5 year plan to provide a good basic care.

    I believe food and health are the two basic needs which must be catered at government level which will make a huge impact on indian’s life going forward.

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    1. Thank you Deepak. 10% of GDP will be a dream and only possible when a really serious govt takes over. Or, when politicians realize that its a vote-swinging issue. The common man is a mere pawn in the hands of these netas who have no value for his life. Sadly, 66 years after independence, Bijli Sadak and Paani continue to be contentious issues in this wonderland.

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  2. As always, lucidly written Salil…

    What an irony with our Govt’ policy on regulation….On one hand we say right to good health is a fundamental right and on the other hand it is proven and seen that we can’t guarantee this to a large section of our population.

    We pride ourselves in offering state of the art care for foreigners where people from other countries flock to India to get good quality, affordable medical treatment, but we Indians are denied even of of the basic amenities.

    Worse is the manner in which this Govt deals with the lobby of spurious medicines, while putting the health of millions of Indians at risk…

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    1. Kannan, you make an interesting point about medical value travel. Of late, even that has moved to the CEE/CIS countries. Sheer negligence plagues this sector as it does others in India too.

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  3. I find this ( your deduction) surprising as to why UPA abandoned the scheme! UPA could have (in the States ruled by it) made each existing hospital give up one or half a floor to treating “Govt’s patients” & new hospitals to build an xtra floor for this. UPA could use the usual cheapest tender for medication for this floor & insist that all newly minted Docs spend 6 months as interns in these hospitals to get their degree. UPA could hve made their UHC work. The reason must be something else – and I can guess what it is..

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    1. Agree with your suggestion. That is ideally what the UPA should have done. However guidance from the NAC doesn’t let it with them having SG’s ears. What is your guess on what the “real” reason is?

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