India is facing deep public distrust and despair over health care in private and public sector hospitals.
Universal Health Coverage must provide a framework in which the issues of access, quality and cost can be integrated.
What are the problems prevailing in public health care?
Access to readily reachable, trustworthy and affordable health care is a major challenge before poorly served rural areas and overcrowded urban areas.
There is an inadequacy of organised primary health services compounded by a weakness at the intermediate level of care in many district hospitals and nursing homes.
Corporate hospitals boast of high quality advanced care and compete with each other for a significant share of medical tourism, they are mostly inaccessible to the rural population and the urban poor.
Government institutions of advanced care suffer from low budgets and a lack of managerial talent.
How India can attain Universal health coverage?
Three major issues are involved in assess health care is access, quality and cost.
The UHC provides the framework in which all three elements can be integrated.
Assess -The pathway to improving access lies in expanding the network of public sector facilities at all levels.
This calls for higher levels of public financing, improved management through the creation of a public health management cadre.
These measures have been envisaged in the National Health Policy, 2017 and need urgent and earnest implementation.
Quality - This is promoted through audited insistence of all service providers who enter this system, and cost is controlled by the negotiating power of the single payer.
Cost of care - It is a major challenge in a system where patients and families have to bear the burden.
The solution lies in doubling the level of public financing to at least 2.5% of GDP by 2019, rather than 2025, as proposed in the National Health Policy.
This can be ensured by pooling tax funding, all Central and State insurance schemes and employer-provided health insurance into a “single payer system”.
