Context
Healthcare as an optional public service will ensure the legal right to receive free, quality care in a public institution
Relevance
GS-II: Government Policies and Interventions for Development in various sectors and Issues arising out of their Design and Implementation.
Dimensions of the Article
- Healthcare vis-à-vis Universal Health Coverage
- Routes to Universal Health Coverage
- Challenges to Universal Health Coverage
- Right to Health Care
- Issues with HOPS
- Tamil Nadu: A Case Study
- Way Forward
Healthcare vis-à-vis Universal Health Coverage (UHC)
- UHC has become a well-accepted objective of public policy around the world.
- Equally effective in Developed and Developing Countries
- Time for India or at least some states to consider implementing UHC.
- Basic idea of UHC is that anyone should not be deprived of quality healthcare because of inability to pay.
- Aneurin Bevan, Founder of National Health Services (NHS-UK) said that – “No society can legitimately call itself a civilized if a sick person is denied medical aid because of lack of means.”
- Idea of UHC inspired the Bhore Committee in 1946 which batted for NHS type health care system.
Routes to Universal Health Coverage
- Two approaches – Public Service and Social Insurance
- Public Service – Healthcare is provided as a free public aid.
- Social Insurance – Allows public as well as private provisions of healthcare but the service is paid for by the Social Insurance Funds and not the patient.
- Basic principles have been same for all the variants of the UHC – everyone should be covered and insurance should be geared to public interest and not profit making.
Challenges to Universal Health Coverage
- Absence of Public Health Centres can lead to patients rushing to expensive healthcare options.
- Containing costs will be a tough as both patient and the insurance provider have a joint interest in expensive care.
- Co-Payments too can exclude many poor patients out of the quality healthcare net.
- Regulating private healthcare providers is challenging as a distinction will need to be made between for-profit and non-profit entities.
- A primary health centre can be productive only if doctors and nurses are on the job and care for patients.
Right to Health Care
- An NHS will not be able to displace the private healthcare sector so soon.
- However, a UHC can be envisaged that would build on primary health care as a public service and can later on converge to some sort of NHS.
- This can be HOPS – Healthcare as an Optional Public Service.
- Everyone would have legal right to receive free, quality healthcare in a public institution if they wish.
- Anyone can avail services of the private sector if they wish but public sector would provide and guarantee decent health services as a matter of right.
- HOPS would be a big step towards UHC though not as egalitarian as NHS.
- Social Insurance can play limited role in this system to help cover procedures which are not easily available in public sector.
- Social Insurance can be made to work mainly with non-profit agendas to avoid the risk of healthcare being tilted to tertiary and expensive care.
Issues with HOPS
- Specifying the scope of HOPS as UHC can’t be unlimited.
- Determining the quality standards of healthcare service.
- Disparity among states in implementing HOPS.
Tamil Nadu: A Case Study
- Tamil Nadu is well placed in terms of making HOPS into reality wit its Right to Health Bill.
- TN already provides most healthcare services in the public sector with good effect.
- Right to Health will be a strong affirmation of the State’s commitment to quality healthcare.
- It would empower the patients and public in general thereby improving the system.
Way Forward
Healthcare is a basic necessity for all. India needs to focus on improving its healthcare in a holistic manner. States like Tamil Nadu and Kerela can mark the beginning of a transformed healthcare sector in India be serving as an inspiration to other states.
Source – The Hindu
