Universal Health Coverage In India: Can It Be A Reality?

By: Rukmini Chopra

Published On: April 09, 2018

Countries worldwide are celebrating World Health Day today, an initiative by the World Health Organization. It was founded on the principle that individuals should be aware of their rights to the highest quality of health. 

WHO is celebrating its 70th anniversary this year and is promoting the concept of ‘Health For All,’ that encourages nations towards Universal Health Coverage. On World Health Day this year, WHO is focussing on UHC and is asking nations to adopt concrete steps to make healthcare accessible to all, without financial hardships.

What is universal health coverage? 

Universal Health Coverage is a system that provides quality and accessible and affordable health services to all citizens of a particular country. It involves providing citizens with a specified package of financial aid benefits and improving the overall health of citizens. UHC doesn't mean free healthcare for all, though it is often mistaken for such an improbable arrangement. 

Countries with the best UHC plans 

There are several countries that have adopted UHC and are setting an example with the way they are administering their universal health coverage system. Here’s a look: 

Thailand 

  • Thailand offers complete financial protection to its citizens and includes medical conditions ranging from a flu to organ transplantation under its healthcare system.
  • Thailand’s public health expenditure is only 3% compared to Brazil and Cuba that have adopted UHC but pay close to 8% of their GDP on health services.
  • The success of Thailand’s healthcare system is primarily attributed to its Universal Coverage Scheme that entails an individual to pay just Rs. 30 baht for consultation fees.

Canada 

  • In Canada, the private sector delivers most of the healthcare services and the government finances the health insurance.
  • The Canadian government pays for 70% of funds on healthcare overall. Many Canadians enjoy private insurance through their jobs, that helps to pay for fees for dentists, optometry as well as prescription drugs.
  • The country spends 10% of GDP on healthcare. 

France 

  • In France, citizens are expected to buy health insurance, that is sold by a small number of non-profit funds financed through the public’s taxes.
  • 70 to 80 percent of costs of healthcare are hence covered by public insurance. More than 90 percent of France’s population opts for voluntary coverage through their jobs.
  • The Ministry of Health in France is in charge of setting the funds and budgets for the coverage plan as well as prescription drugs. It also is responsible for checking the equipment in hospitals. 
  • France spends close to 11.8 % of GDP on health.

The health situation in India 

In India, the National Health Protection Scheme or ‘Modicare’ was initiated under the Union Budget, 2018.

  • The scheme promises health insurance to a 100 million families, with a cover of Rs. 5 lakh each. In total, the plan covers 500 million individuals. 
  • Though India seems to be making progress in terms of its move towards Universal Health Coverage, which it plans to adopt in 2030, there are certain severe healthcare issues that need to be tackled before we can count ourselves in the list of countries with the best healthcare plans.
  • India’s out-of-pocket expenditure is at 60%, the highest in the world. 
  • The government hospitals in India are in a poor state. Less than 42% of urban and 46% of rural population opts for public healthcare services owing to the lack of medical facilities, equipment in government hospitals along with accessibility to nearby clinics. 
  • There is a need for subsidized rates at private hospitals. The treatment for cancer, and other transplant surgeries in India is exorbitant.
  • The average cost of three day hospitalization in the private hospitals is close to Rs. 25,000 as opposed to Rs. 4,500 in government hospitals. 

5 steps towards UHC 

Here’s what India needs to tackle to be able to adopt universal health coverage: 

  • Political alignment: If political parties remain divided and do not share the same level of passion to make UHC a reality, we will be stuck. There needs to be a high level of commitment by the parties to invest in health.  Ministries of finance as well as human resources need to work closely with the Ministry of Health to achieve the target. 
  • Inclusion of varied organizations for implementing UHC: There needs to be a massive brainstorm between varied institutions and organizations and not just run by the government. There is a need to rope in non-governmental as well as private organizations that can make suggestions on how to make the UHC plan stronger. 
  • Taking a cue from other nations: We cannot replicate the healthcare plans of other countries, considering our demographics are very different. But we can take cues from countries like Thailand, that spend as much as us from their GDP on health. Like Thailand, we can make our district healthcare system more efficient and qualitative. 
  • Need for focus on public funding: While private sectors play an important role in contributing to health by providing umpteen services, the Indian government needs to focus on adequate public funding (resources provided by government to political parties) to improve the quality of healthcare services. 
  • Setting a specific set of indicators to monitor UHC: A set of indicators such as IMR (Infant Mortality Rate), MMR (Maternal Mortality Rate), life expectancy are needed to monitor the efficiency of  the UHC system . The same can also be judged if the data is measured according to geographical areas, economic backgrounds and gender. 

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