Universal Health Coverage is the theme of this World Health Day
- More than seven years have passed since the High Level Expert Group of the erstwhile Planning Commission outlined the way ahead on India’s road to Universal Health Coverage (UHC)
- According to National Health Profile 2017 100 crore Indians do not have health insurance
- Government data shows 60 lakh Indians face impoverishment
- Last month cabinet passed a proposal to provide a health cover of Rs 5 lakh per year to 10.74 crore families; there is an unstated hope that it will eventually become India’s blueprint for Universal Health Coverage but concerns about finances linger
This World Health Day, these hard numbers tell the India story. It is not glorious. The theme this April 7 is Universal Health Coverage (UHC) – something WHO director general Dr Tedros Adhanom Ghebreyesus is known to be passionate about.
There are already dissensions and doubts on the long overdue health plan – now christened the National Health Protection Mission. For one the premium calculation based on which the proposal for cabinet nod is mired in doubts. After the first consultation with insurance companies the Rs 1100 premium per family per year has found absolutely no takers. Insurance companies say the feasible figure is Rs 2500.
On the other hand the secondary/tertiary care model is in itself problematic – if experience from states is anything to go by it may land the government in a vortex of more and more expensive tertiary care procedures. Because they are paid for and the scheme does not in any way incentivise preventive and promotive health care at individual or institution level.
The importance of prevention and lifestyle adjustments in healthcare was reiterated earlier this month in a study published in the American Journal of Medicine that found that death rates from heart disease and stroke in adults under age 65 are lower and dropping faster for Kaiser Permanente members in Northern California than in the rest of the United States.
America’s leading healthcare provider, Kaiser Permanente health plan focusses on technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management.
While India has also announced a plan for 1,53000 health and wellness centres for the purposes of prevention, the fact that this is not linked to NHPM would mean that they would continue to work in silos. What’s more because private entities that will partner the government or even government centres have no stake in the health of the patients they serve, the culture of tertiary care interventions will receive a fillip.
Lack of funding in healthcare is not the only impediment on the UHC road for India. Health plans are rarely thought through.
