It took us 15 long years to finally get a National Health Policy. However, though the 2017 policy paints an elaborate picture of what must be done to achieve universal health coverage (UHC) by 2030, it comes with several gaps and a lack of clarity that could impede our efforts in bringing this plan to fruition. As they say, the devil is in the details, and the NHP 2017, unfortunately, falls short where details and actionable next steps are concerned.
The target numbers proposed for increased health spending, hospital beds and human resources do not come remotely close to what is needed for India to meet its UHC goals. The government's proposed increase in public health spending to 2.5% of India's GDP still lags behind the recommended spending of 5% of GDP on health. The NHP also mandates the creation of a National Healthcare Standards Organisation (NHSO) to fix standards for healthcare institutions in the country and to develop "evidence-based standard guidelines of care" applicable both to the public and private sector. Again, the role of the Centre and states in this area remains unclear.
As they say, the devil is in the details, and the NHP 2017 unfortunately falls short where details and actionable next steps are concerned.
The goal of universal health coverage is to ensure that all people can access health services without suffering any financial hardship. For this to happen, it is clear that much more needs to be done to help vulnerable patients access quality healthcare services at affordable prices in the country. The role of health insurance becomes critical here. Only about 20% of Indians have some form of health insurance. I believe the upper middle class should be incentivised for insurance, based on job description, while for those below the poverty line, the government could consider stepping in with a cross-subsidy plan. This will help increase access to high-end care and reduce the burden on individuals and groups who are otherwise unable to access such health services.
I believe that the National Health Policy sets out a grand plan, but does not provide a clear roadmap for achieving our goals. For instance, how do we go about reducing the increasing obesity for people in the middle and upper class? In rural areas, how do we improve hygiene to reduce cervical cancer rates? How can we decrease the incidence of smoking amongst youth? Could we perhaps implement tobacco taxation to tackle such chronic diseases and use this funding to encourage private enterprise to address issues concerning these conditions? I would like to see the government form a committee by involving private leaders in healthcare, particularly those in cancer and cardiac care, who understand the ground-level problems and whose expertise can help us address the nation's health needs in a more effective manner.
For us to achieve universal health coverage by 2030, it is critical for all stakeholders to be aware of the roles they must play to contribute to this mission.
A positive aspect of the NHP 2017 that stood out for me was the government's aim to foster a stronger partnership with the private sector. The policy looks afresh at strategic purchasing from the private sector and leveraging its strengths to achieve our national healthcare goals. Since private facilities deliver over 70% of healthcare services in India, this greater involvement of the private sector should definitely be seen as a good move for our health system in the years to come.
Like in the case of education, I look forward to the day when health is recognised as a human right so that every single person in the country has access to it. For us to achieve universal health coverage by 2030, it is critical for all stakeholders in the country to be aware of the roles they can and must play to contribute to this mission. I am sure that most members of the private health sector will agree with me when I say that it is important for us to know and understand how we can work with the government and other stakeholders to implement measures and initiatives that will take us many steps closer to UHC.