Course :- Burning Issues Decoded (BID) Lesson - Health Care in India(1/3) Presented By Nithin Kunneparambil
Context . India to increase public health spending to 2.5% of GDP: PM Modi [ Economic Times, Dec 12th] Health Ministry notifies four more devices under Drugs and Cosmetics Act [ The Hindu Business line, Dec 9th]
Preston Curve The curve relates GDP Preston curve (2005) per capita with Life Expectancy 90 85 80 . Can you see a flattening / Plateauing after a certain degree of investment. 101 Life Expectancy-6.6354'Ln GOP per capita+10.754 65 14 Much of the focus was on Primary healthcare Now issues are more towards life style diseases. 50 20000 30000 40000 50000 70000 GDP per capita (constant international 2005 $)
The models for Health . American Model . German Model . Chinese Model . What is Indian Take?
Certain definitions . Primary HealthCare :- First level of contacts. Family planning, immunization, Prevention of Endemic disease, common diseases/Injuries etc. In India we have PHC, Family welfare centre fore very 30,000 people . Secondary Health Care : - Sepecialist in Higher hospitals. In India this means District Hospitals, Block level community health centres. Teritiary Health Care:- ICUs, advanced diagonostic supports. In India this is done my medical colleges and med research institutes.
AYUSHMAN BHARAT The Health Revolution in India Considered as the single largest health scheme in the world Also called as ModiCare But wait, Isnt Health in the state List? What is Modi doing here then?
State List . Public Order . Officers and Servants of HC . Land . Fisheries Trade and Commerce .Markets and Fairs Prisons Local Governments. Public Health Pilgrimages Intoxicating liquors Relief for disabled and unemployed Agriculture Money Lending and money lenders . etc
Centrally sponsored scheme The money is borne by the states and Centre on a sharing basis. (60:40 in this case) aSIS Usualily in the states domain. Just to give addition impetus. Account to 10% of the total expenditure of the Union. Usually done along with the cycles of Planning commission. Now there is no Planning Commission, so what happens? All the 28 centrally sponsored schemes have Sunset clauses except MGNREGA under Ministry of Rural Development. . QUESTION:- WHAT IS THE DIFFERENCE BETWEEN CENTRAL SECTOR SCHEME and CENTRALLY SPONSORED SCHEME?
AYUSHMAN BHARAT med as Ayushman Bharat Pradhan Mantri Jan Arogya Yojana PM JAY Will cover 10 Crore Families50 Crore Beneficiaries Subsumes . Rashtriya Swasthya Bima Yojana . Senior Citizen Health Insurance Scheme The sum of Rupees 5 Lakh per family . For Secondary and Tertiary Care hospitalization.
Questions Consider the following 1. AB NHPM is a scheme Care requirements. Centrally sponsored schemes have out done its purpose in India, especially in an era of cooperative Federalism. Analyse. statements implemented doesn't take cover the Primary Health 2. AB NHPM funding is on 60:40 in all the states a. 1 Only b. 2 Only c. Both d. None
Course :- Burning Issues Decoded (BID) Lesson:- Health Care in India (2/3) Presented By Nithin Kunneparambil
Health Financing in India Household out of pocket ExpenditureGovernment sponsored health insurance Local Bodies and other schemes Private Health Insurance 4% 796 22% 67%
Existing Scheme RSBY Vs AB NHPM Parameter Coverage Services covered Limited Premium Population 18 O Ayushman Bharat 5 Lakh Covers high end procedures RSBY 30,000 300 400 INR Mixed 50 Crores Covered
Implementation strategy AB NHPM Agency to be put in place. And at state we will have State Health Agency They can either the scheme through . Trust/ Society . Insurance Company . Integrated model.
However many state aren't enthu . States like Kerala, Telangana, Punjab, Delhi and Odisha are speaking against it These state interesting have some politics behind this Much to the fact that these states interesting have better health care systems as well. Kerala alone claims almost 50% of the total claims as per RSBY.
Is Avushman Bharat the only thing? Integrated approach about Health, Rural Development, chemical Industry, AYUSH, Consumer affairs, WCD Ayushman Bharat . Mission IndraDhanush National Nutrition Mission -Health and Wellness centres Medical Students seats increased considerably Swachata promoted . Yoga Promoted.
Course :- Burning Issues Decoded (BID) Lesson:- Health Care in India (3/3) Presented By Nithin Kunneparambil
Future course of actions Progressively and incrementally to include more equipments under its ambit . MRI . CT Scan Dialysis PET Defribrillators Bone Marrow Cell instruments. Implantable instruments.
Drugs Technical Advisory Board . Highest statutory decision making body Constituted as per drugs and cosmetics Act, 1940 Part of the central drugs standards control Organization in the ministry of Health and Family welfare