In the last decade, the increasing cost of care and consequent impoverishment of those seeking medical treatment added momentum to the debate on ‘Right to Health’ by demanding universal health coverage (UHC) to build societal resilience to the devastating impacts of ill health. However, realising this dream of UHC and Right to Health mandates allocating the maximum available resources for health in the face of multiple development challenges.
Public health spending as a percentage of GDP has hovered around an average of 1 per cent against the global average of 8 per cent, constraining the building of a rights-based healthcare system. In 2018, India’s public health spending as a percentage of total health expenditures was 26.95 per cent, against the global average of 59.54 per cent with just 20 countries spending less than India. At 62.67 per cent out-of-pocket expenditure on health, such spending in India was the 13th highest in the world.
In addition to low public health spending, key barriers to universalising access to healthcare are the inadequate availability of services, particularly in rural areas, a severe shortage of human resources and the rising cost of care due to more intensive use of technologies alongside changing perceptions of quality.
The health system inadequacies highlighted by the COVID-19 pandemic has provoked the Rajasthan government to introduce the Rajasthan Model of Public Health (RMPH) in its budget for 2021-22, embedding in it a public health law-making access to health a right. For realising this aspiration, Rajasthan has proposed doubling its budget, setting up medical and nursing colleges, establishing and upgrading primary health centres and substantially improving the delivery of services by expanding access to free medicines and diagnostics, besides adding 1,000 beds and establishing institutions of excellence for cardiology, virology, cancer and maternity and childcare.
New features to its current health insurance programme are three — expansion of the eligibility criteria to cover two-thirds of the population, providing 50 per cent subsidy for the non-poor sections to avail of the health insurance programme by providing them cover for Rs 5 lakh worth of cashless treatment in government and accredited private hospitals, and assuring coverage of not just inpatient but also outpatient treatment.
Attaining this herculean feat would require uncompromised attention to improving the primary healthcare infrastructure over the next decade. This, however, requires a doubling of resources that are unavailable, necessitating reviewing interventions to remove waste, promote efficiencies and more rational use of the limited resources. The road ahead looks bumpy but not untraversable.
This article was written by former Union Health Secretary Ms K Sujatha Rao and published in The Indian Express
Read more at https://indianexpress.com/article/opinion/columns/rajasthan-budget-healthcare-covid-19-7234817/
