Context:

• Recently, the Union Ministry of Health and Family Welfare has organized an event to mark Universal Health Coverage Day. 

 

About Universal Health Coverage Day:

• It is celebrated annually on December 12 and is promoted by the World Health Organization.
• December 12 is the anniversary of the first unanimous United Nations resolution calling for all nations to provide for their citizens affordable, quality health care.
• 2020 THEME: Health for all, protect everyone.
• UHC is promoted as an instrument to help advance the more broadly conceived human right to health, based upon a number of international agreements.
• Universal health coverage has been included in the new Sustainable Development Goals for 2015-2030, adopted by the United Nations. 

 

Universal Health Coverage:

• UHC means that all individuals and communities receive the health services they need without suffering financial hardship. It includes the full range of essential, quality health services from health promotion to prevention, treatment, rehabilitation and palliative care.
• Goal of UHC: As stated in the United Nations Sustainable Development Goals (SDG 3) is one of the most significant commitments to equitable quality healthcare for all.

 

 

Benefits of UHC:

• Enables everyone to access the services that address the most significant causes of disease and death, and ensures that the quality of those services is good enough to improve the health of the people who receive them.
• Protects people from the financial consequences of paying for health services out of their own pockets and reduces the risk of people getting pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.

 

 

 

An Indian Perspective:

• Meaning: That all individuals and communities receive the health services they need without suffering financial hardship. It includes the full range of essential, quality health services from health promotion to prevention, treatment, rehabilitation and palliative care.
• Goals of UHC: To make healthcare more accessible, more equitable and more effective. This requires:
  • A strong, efficient, well-run health system;
  • A system for financing health services;
  • Access to essential medicines and technologies;
  • A sufficient capacity of well-trained, motivated health workers.
• Some of the initiatives for UHC in India: 
  • National Health Policy 2017: It envisages the attainment of the highest possible level of health without anyone having to face financial hardship as a consequence.
  • Mission Indradhanush: One of the largest global public health initiatives launched in 2014, to boost the routine immunization coverage in the country.
  • Ayushman Bharat: Its two wings - the Health and Wellness Centres (HWCs) and the Pradhan Mantri Jan Aarogya Yojana (PMJAY), are making quality healthcare affordable and accessible for crores of people in the country.

 

Ayushman Bharat

• Ayushman Bharat adopts a continuum of care approach, comprising of two inter-related components, which are:
• 1. Health and Wellness Centres (HWCs).
  2. Pradhan Mantri Jan Arogya Yojana (PM-JAY).
• It aims to bring quality healthcare to around 50 crore poor and vulnerable Indians (based on the Socio-Economic Caste Census (SECC) data)
• PM-JAY is world’s largest health insurance fully financed by government which will provide free coverage of up to Rs 5 lakh per family per year at any government or even empanelled private hospitals all over India for secondary and tertiary medical care facilities.
• Centrally sponsored scheme with contribution from both Centre and State 
• Cashless access to health care services for the beneficiary at the point of service.
• Wellness Centres: The 1.5 lakh sub-centres that are converted into wellness centres will cater to majority of services such as detection and treatment of cardiovascular diseases, screening for common cancers, mental health, care of the elderly, eye care, etc

 

What are the major problems of Health sector in India?

• After the independence the focus has been increased significantly on Health status of people. As a result, there has been a significant increase in life expectancy of people from 35 years to 65 years.
• However, it is unevenly distributed in different parts of the country. The health problems in India are still a cause of concern.
• As the income levels of the people have increased there is spurt in non-communicable or life style diseases which accounted for nearly half of the deaths.
• The existing healthcare infrastructure is just not enough to meet the needs of the population. The central and state governments do offer universal healthcare services and free treatment and essential drugs at government hospitals.
• However, the hospitals are understaffed and under-financed. People living below poverty line continue to rely on insufficient health care facilities in rural areas.
• India has one of the lowest per capita healthcare expenditures in the world. The high out-of-pocket expenses in India stem from the fact that majority of Indians do not have health insurance.
• Moreover, majority of the skilled health care professionals happen to be concentrated in urban areas. This is the main reason for rural- urban disparity in terms of healthcare.

 

Healthcare challenges in India:

1. The country’s diversity in terms of geography, culture, and demography
2. Political system
3. Unsafe boundaries
4. Huge population burden
5. Poor investment in health

 

Challenges in implementation of UHC:

• Identifying services: That are to be universally provided to begin with and what level of financial protection is considered acceptable. 
• Huge mobilisation of services: Offering health services to the entire population is not economically feasible and demands huge resource mobilisation.
• Prioritising certain services: To the poor and vulnerable sections to ensure both access and affordability, while leaving the rest of the population for coverage at a later stage is also not a good option.

 

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”.