The emergence of novel coronavirus disease 2019 (COVID‑19) pandemic provides unique challenges for the health system. In this paper, the authors used economic underpinnings to explain several of these challenges and suggest a way forward for health policy, during, and after the COVID‑19 pandemic in India.
- Historically, health systems in India are wrought with low public spending on health, with 1.5% of gross-domestic-product (GDP) being spent on health by the government. The recent COVID‑19 pandemic has exposed this historic perpetual underfunding of the health system in India and given the UHC aspirations, the stimulus funding of ₹15,000 crores fall short by a mile.
- Since most of the healthcare services in India are provided by the private sector, many state governments in India have started looking out toward the private sector for the provision of COVID‑19 treatment. This provides the opportunity of purchasing healthcare from hospitals either through global budgets or bundled case-based payment.
- Country-wide lockdowns have restricted the provision of other services – maternal & child health services, tuberculosis, dialysis, radiation therapy etc. which are likely to have significant health and economic consequences at the population level.
- Another major impact of the COVID‑19 pandemic has been at the micro and macroeconomic level. It has impacted the household income and its resultant consumption.
- The recently set up Health Technology Assessment Board correctly outlined three criteria to provide recommendations for decisions on resource allocations – health maximization, equity in healthcare utilization, and reduction in out‑of‑pocket expenditures. However, COVID‑19 interventions have significant externality on non‑COVID health services and incur significant non-health sector costs. As a result, the definition of a societal perspective to be used in analysis increases manifold.
COVID‑19 pandemic has significant lessons to learn for health and public policy. From increasing investments in the health sector to purchasing care & setting provider payments and setting up public provisioning systems for healthcare and reducing the reliance on purchasing healthcare from the private sector. Finally, the management of the COVID‑19 pandemic, which has involved all the sectors of government, provides an opportunity to further advance the cause of health‑in‑all policies.
Read more at: Prinja S, Pandav CS. Economics of COVID-19: challenges and the way forward for health policy during and after the pandemic. Indian J Public Health. 2020;64:S231–3.
