Right to Health or UHC, the Ayushman Bharat way; India will decide

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Aadhar, Aayushman Bharat
Right to Health or Universal Health Coverage; which approach will work in India?

The Indian electorate has to choose between Congress promise of Right to Health and NDA approach of Universal Health Coverage through Ayushman Bharat

Right to Health Vs Universal Health Coverage that is Ayushman Bharat.

As India’s election fever reaches fever pitch – the first phase of polling is due on April 11 – this is also how battle lines are being drawn. Congress has promised Right to Health in its manifesto while BJP’s social sector calling card this election season is Ayushman Bharat – the first step towards Universal Health Coverage (UHC).

No matter what the outcome, it is safe to say that 2019 will go down in the history books as perhaps the first election when an electoral conversation – however muted – has been framed by both major contenders on the issue of health.

In its recently released manifesto , Congress has promised to “enact the Right to Healthcare Act that will guarantee to every citizen the right to healthcare services, including free diagnostics, out-patient care, medicines and hospitalisation through a network of public hospitals and enlisted private hospitals.”

On the other side the NDA government is betting big on the outreach it achieves through the Ayushman Bharat programme to real electoral benefits. Launched last year Ayushman Bharat has two arms – the preventive healthcare arm under which 1,53,000 health and wellness centres are being set up and the Pradhan Mantri Jan Arogya Yojana. PMJAY aims to provide an annual health cover of Rs 5 lakh to 10.74 crore families.

To put it simply, while Congress is banking on a demand based approach when theoretically at least, a person can take the government to court for being denied healthcare, NDA has adopted the supply side approach. This, the government hopes will be the first step towards UHC

To put it simply, while Congress is banking on a demand based approach when theoretically at least, a person can take the government to court for being denied healthcare, NDA has adopted the supply side approach. This, the government hopes will be the first step towards UHC.

WHO defines UHC as: “Universal health coverage (UHC) means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.”

In some sense one is a precursor of the other. In an open letter on the occasion of World Health Day, Ayushman Bharat CEO Dr Indu Bhushan wrote on Sunday: “Ayushman Bharat has been founded on the conviction that every person, man or woman, rich or poor, old or young, must have access to quality healthcare not as a matter of privilege but as a matter of right…PMJAY is one significant step towards and an investment in achievement of universal health coverage (UHC)…”

NDA too had in fact started out on this course with a Right to Health charter which was a part of the draft National Health Policy of 2015. But daunting as the task looked in the face of crippling manpower shortage – Niti Ayog data shows that doctor-to-population ratio for India is 1:1655, against a WHO norm of 1:1000 – the government quickly backtracked and opted instead for an assurance approach in 2017 when the policy was finally passed.

Game on now. Over to the Indian electorate.