unacademy 25th January 2019 Important Editorial Discussion(MOVING AWAY FROM 196) Presented By: Prabhakar Jha
Historically, Low spending and interventions on Health from Centre and States: . India has not invested in health sufficiently, though its fiscal capacity to raise general revenues increased substantially from 5% of GDP in 1950- 51 to 17% in 2016-17. . India's public spending on health continues to hover around 1% of GDP for many decades, accounting for less than 30% of total health expenditure . Besides low public spending, neither the Central nor the State governments have undertaken any significant policy intervention, except the National Health Mission, to redress the issue of widening socioeconomic inequalities in health . But the National Health Mission, with a budget of less than 0.2% of GDP, is far too less to make a major impact. And worryingly, the budgetary provision for the NHM has decreased by 2% in 2018-19 from the previous year.
National Health Policy 2017 envisaged raising public spending on health to 2.5% of GDP by 2025; . The Policy seeks to reach everyone in a comprehensive integrated way to move towards wellness. It aims at achieving universal health coverage and delivering quality health care services to all at affordable cost. It seeks to promote quality of care, focus is on emerging diseases and investment in promotive and preventive healthcare. The policy is patient centric and quality driven. It addresses health security and make in India for drugs and devices. . In order to provide access and financial protection at secondary and tertiary care levels, the policy proposes free druqs, free diagnostics and free emergency care services in all public hospitals.
Clear trends that India needs to adopt: Two important trends can be discerned: . tend to invest more on health, and paid out of the pocket declines. Economists have sought to explain this phenomenon as "health financing transition", akin to demographic and epidemiologic transitions. Economic, political and technological factors move countries through this health financing transition. Of these, social solidarity for redistribution of resources to the less advantaged is the key element in pushing for public policies that expand pooled funding to provide health care. Out-of-pocket payments push millions of people into poverty and deter the poor from using health services. Hence, most countries, which includes the developing ones, have adopted either of the above two financing arrangements or a hybrid model to achieve Universal Health Care (UHC) for their respective populations. . For example, according to the World Health Organisation's recent estimates, out-of-pocket expenditure contributed only 20%to total health expenditure in Bhutan in 2015 whereas general government expenditure on health accounted for 72%, which is about 6% of its GDP. . Similarly, public expenditure represents 2%-4% of GDP among the developing countries with significant UHC coverage, examples being Ghana, Thailand, Sri Lanka, China and South Africa.
Measures that need immediate Implementation are: District hospitals are to be strengthened, to provide several elements of tertiary care alongside secondary care. Sub-district hospitals too would be upgradec . A National Healthcare Standards Organisation is proposed to be established to develop evidence-based standard management guidelines. A National Health Information Network also would be established by 2025 A National Digital Health Authority would be set up to develop, deploy and regulate digital health across the continuum of care.
GS And GA faculty @ Mahendra's Coaching Institute. Teaching Polity, and international relations for 7 years