The 65th World Health Assembly meeting in Geneva has identified universal health coverage as a key imperative for all countries, if their goal is to consolidate the public health advances achieved so far. Several countries have been working to reform their health system over the past two or three decades. The Assembly, which is the decision making body of the World Health Organization, adopted the concept of Universal Health Coverage in 2005. China launched an ambitious UHC plan three years ago, and with some caveats, has made significant strides. A review of the Chinese programme reported in March this year in The Lancet shows that medical insurance coverage of the population rose from 29.7 per cent in 2003 to 95.7 per cent in 2011. At the same time, the review shows that coverage alone did not reduce financial risks for patients because of rising costs, including profit seeking in care provision. What this implies is that any reform must aim at improving the public hospital system, raising the quality of care, creating benchmarks, and introducing transparent regulatory processes. India's nascent effort to achieve UHC will take shape during the Twelfth Plan and it will do well to learn from global examples. It is vital that the Planning Commission and the Centre draw the correct inferences from international best practice.
Among the many examples available to India on national universal health coverage schemes is that of neighbouring Thailand. Arguably, the most important outcome of the 10-year-old UHC programme in that country is a dramatic reduction in the number of non-poor households that fell below the national poverty line because of private health expenditure. Moreover, both outpatient visits and hospital admissions increased, as a result of universal access to care. The Thai reform programme stands out as a bold initiative because it was undertaken in the wake of the Asian financial crisis of 1997. It progressed on equity objectives by adopting a tax-funded model, strengthening primary care and disease prevention, and crucially, capping provider payments to regulate costs. India faces a challenge on these very issues with rising costs of private care and insurance payments that few can afford. Fortunately, it has its own remedial blueprint prepared by the High Level Expert Group on UHC instituted by the Planning Commission. The report of the panel is available on the Internet at http://uhc-india.org/. With a stronger economic base now, India can undertake what Thailand did a decade ago. But speedy progress will depend on all political parties convincing themselves that universal health coverage is a citizen's right and an investment in future economic growth.
Keywords: universal health coverage, WHO, medical insurance
Dear Satish,
You have forgotten to mention the case of water privatisation in Brazil, the harvest of private corrier services in India by displacing cheap postal services, can Satish agree the disappearance of cheap post cards from the minds of common man and running after the corrier services mashrooming around. Please don't make every attempt to support privatisation. Privatisation in the light of world wide experience is not appropriate to Indian situation, we have to expand the scope of schemes like National Rural Health Mission (NRHM)and start effective monitoring system in the government health service centers. Privatisation of health care services is not at all a solution to improve the quality and outreach of health services to the poor, it can be fullfilled only through strengethening the government health system.
it is rational and sensible idea for our country to universalize
health coverage. because though numerous health related schemes have
been launched by our government for the betterment and improvement in
the health sector .here also tardy implementation ,poor service
delivery system,inadequate infrastructure....etc are the problems
plaguing our health sector.so better implementation ,transparency and
uhc will help immensely to bring revolutionary change in the health
sector.as article manifested the example of thailand and china which
have ripe fruit through ppp basis.same strategies with with little bit
realignment can prove helpful to country too.
Sir, it is a very bad idea that the govt is the solution for good
health care.Govt is the problem it is not the solution.Free markets
will provide the best quality service at the minimum price
possible.But the rising cost of health care is depreciating
rupee.Don't blame the so called evil doctors for rise in the health
care costs,instead blame the rupee.Because health care cost is
actually decreasing when it is measured in gold.The govt was in
control of the telecom industry prior to year 2000 and we can see the
results for ourselves what was the telecom industry before year 2000
and after 2000.I hope you don't want the govt success in telecom prior
to year 2000 to be replicated in health care. If that is the case the
biggest losers will the people of this country.Universal health care
is socialism under new name.It was not successful in either soviet
union or north korea it is not to be so in or country as well.
"health is wealth"
very old saying but if we put some stress on our mind..actually it is circular phenomena,health gives wealth,wealth gives health.india,we are booming,a developing economy with most favourable demographic dividend.an to ensure that this rising streek should continue .we need to maintain health,of this ,huge manpower...
india is very ambitious in this both broad targeted programme to narrow targeted program is been in shape..but leakouts,inadequate infrastructure,shortage of skilled staff are the road blocks...
thai and india we cannot compare them...yes they did congrats to them..but we have different kinda political system,decision making,and huge population to be addressed ..
India aims the universal health care for all.In health care coverage Indi,s performance in funding tertiary level government institution is abyssmal. The annual budget from UGC to JNMC since 2005-06 till date is Rs 2.10 Crore, that is just Rs 54.79/day/patient which is highly insufficient to provide medicine, linen, food, other facilities to the patients. A sharp increase in inflation and steep rise in the cost of essential commodities as well as services, it seems, have not at all bothered the central government as if JNMC or people benefiting from it are not part of India.
But other central government hospitals under the Ministry of Health & Family Welfare (MOHFW) are not in such pathetic condition. They are getting a minimum of Rs 250 to Rs 300/day/patient.Now we can undestand the disparity in funding of Institutions of health. How can we acheive health care?? The populous state UP & bihar patients comes to delhi for all tertiary care because GOI donot fund their central hospital
Appreciation of private sector in health facilities have hampered the government's goal of equity. These private hospitals have created a huge disparity between rich and poor in context of medical services. UHC has become the need of the hour. Planning commission have to ensure that government health facilities are not lagging behind. Then a must health insured life of its citizens is mandatory. A strong political will along with the strong will of health professionals together can bring about this goal. Remember green revolution brought equity in our agriculture and a similar kind of revolution is needed in the medical field.
Good that Hindu is still focussing attention on the importance of public health. As
noted in the article, Thailand is a great example of universalizing access to health
and also spending national resources, and not grants or loans, on public health.
From my own experience, I can also vouch for the quality of the country's medium
and small private healthcare enterprises. Some of our big names cannot hold a
candle to their nursing homes. We need a perspectival shift. Mindless corporatisation
just jacked up every input cost in healthcare in India and now the so called
"corporate" hospitals, which are no better than a mission hospital in Bangkok, are
poor in quality and high in prices. Funny that in India everything goes wrong.
Perhaps we need a real crisis like the 1997 currency crisis in east Asia.
There is enough evidence around the world that UHC is the best way forward to have a stron economy. Free market economics has largely messed up health in our country. Its time we look at evidence rather than harp upon neo-liberal reforms
With nostalgia I recollect my childhood days... when Primary Health Centres run by Panchayat Union hospitals had enough stock to serve the poor and middle classes! For ordinary fever nothing spent by us!...even, approaching the hospital in distance we did not mind! But the present plight of the many government hospitals sans medicines, diverting the poor to approach the pharmacies-all point towards a crisis.In addition to the example of People's Republic of China, the development in health-care in Cuba could be cited. In spite of the sanction by the US and allied countries, the tiny nation has achieved success in life expectancy of her citizens. American filmmaker Michael Moore's celebrated documentary SICKO portrays this; the film was an eye-opener to many US citizens who were very much critical of Moore in the initial stage turning as great supporters now!They stand by him in OWS protests. Healthcare insurance was the first agenda taken by the Obama administration thanks to Moore!
Endemic corruption and lack of political will to get anything done, anything at all will likely sink our UHC plans. Let's hope for the best still. Thailand's example is really an exception though. It is hard to recall another country that turned its healthcare system around that well and that fast. A key point was also Thakshin Shinawatra's will to push the reform through and concentrating on maximizing healthcare services with limited means, i.e. targeting basic healthcare which is most effective. The other pillar there was the focus of generic drugs largely imported from India or breaking patents to address the rampant HIV-epidemic in Thailand. Do we as a people and our leaders have the will to introduce such an ambitious reform? Time alone will tell.
Universal health coverage has never been more distant than now in India, what with our present set of planners sold on privatization as the way out of the myriad ills. The experience of Thailand, perhaps as unequal as even more than India, should be some eye-opener, at least help activists put across their case strongly. Dr. Prateep Dhanakijcharoen, deputy secretary general of Thailand's National Health Security Office, says, We would like to let the world know that it’s not necessary to launch a universal health-care system only when the money is there; what is important is to work steadily on it. But dedication is a must.”
Where shall we start.With a "declared"Population of 36 to 40 Crores
living under abject poverty all "Schemes"with long names have been proved "failures"because there IS a Lack of Will by the Central as well as State Govts.The benefits declared do not percolate down to the needy and like a Basket "Full"of Water nothing reaches the poor who suffer malnutrition,starvation and basic health care.
The Systems Need REVOLUTIONARY changes and Only an Administration which fulfill the Responsibility Entrusted on it ONLY can do this.
WHERE DO WE FIND PEOPLE TO RUN SUCH AN ADMINSTRATION.
NHRM was a scheme launceh for improving health care facilities, the
medicines assigned for diseases like T.B, AIDS and Malaria were
disrtibuted free of cost , Use of iodine in salt was encouraged and
the last heroic act by Aamir khan in Satymev Jayte's form. The state
is doing much for the betterment of health care facilities but the
same old corruption is proving a menace here also, with most of the
funds for medicines, mid-day meals being gulped down by the domestic
leaders.
Alex Paul Menon was an administrative officer who along with his 3 friends formed a group which he loved to call "Crazy four " were
taking mesures for the same at their levels and the urgent need of
adminstrative officers like him can be a vital step in this regard.
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