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.