Context:
Universal health coverage (UHC) embodies the principle of providing all individuals with unrestricted access to comprehensive, top-tier healthcare services, without imposing financial burdens. UHC guarantees that individuals can access healthcare whenever and wherever they require it, encompassing a wide range of essential health services, spanning from health promotion and prevention to treatment, rehabilitation, and palliative care. The provision of these services relies on robust, efficient, and fair healthcare systems deeply embedded within communities.
Relevance:
GS2- Health
Mains Question:
A populace in good health is a populace empowered. In this context, discuss the constitutional safeguards available to ensure universal Health Coverage (UHC). What place does health occupy in the political parties’ proposition(s) for the upcoming Lok Sabha elections? (15 Marks, 250 Words).
More About Universal Health coverage (UHC):
- UHC is founded on the idea of enhancing primary healthcare to ensure the holistic addressing of all health needs, backed by a skilled and adequately supported healthcare workforce.
- On December 12, 2012, the United Nations General Assembly unanimously supported a resolution urging nations to hasten their advancements towards Universal Health Coverage (UHC).
- In India, the high-level expert group’s report, presented to the Planning Commission in 2011, outlined the government’s intention to boost public healthcare financing to 2.5% of India’s GDP during the 12th Plan (2012-17). The country’s economic growth makes this increase achievable.
- The National Health Policy of 2017 articulates its goal as “achieving the highest possible level of health and well-being, and ensuring universal access to high-quality healthcare services without imposing financial hardship on anyone,” which is in line with the objectives of UHC.
Constitutional Safeguards:
In India, there is no explicit constitutional provision establishing the fundamental right to basic health.
- However, the Directive Principles of State Policy outlined in Part IV of the Constitution serve as a foundation for the right to health.
- Article 39 (e) of the Constitution mandates the state to ensure the health protection of workers; Article 42 underscores the importance of fair and humane working conditions and maternity benefits; while Article 47 obligates the state to elevate nutrition levels, raise the standard of living, and enhance public health.
- Notably, the Constitution not only requires the state to promote public health but also delegates authority to local governing bodies such as panchayats and municipalities to bolster public health under Article 243G.
Significance of UHC:
- The International UHC day theme, ‘Health for all: Time for Action,’ and the World Health Day theme, ‘my health – my right,’ prompt a consideration of how access to healthcare should be conceptualized.
- Given that health falls under state jurisdiction and UHC policies are crafted at the national level, there’s a pressing need for discussions on implementation.
- India’s substantial migrant population, with approximately 41 million inter-state migrant workers (Census 2011) and a migration rate of 28.9% (Periodic Labour Force Survey, 2020-21), along with 49% of the population residing in urban slums (UN-Habitat/World Bank), highlights the importance of prioritizing the availability and accessibility of primary healthcare services.
- Isaiah Berlin delineated two forms of freedom: ‘freedom from’ or negative freedom, and ‘freedom to’ or positive freedom.
- ‘Freedom from’ entails the absence of hindrances or constraints, whereas ‘freedom to’ acknowledges the capacity to independently determine and achieve individual or collective goals.
- The discourse surrounding health as a human right should align with the concept of ‘freedom to,’ where every citizen has the opportunity to attain health and well-being as part of their entitlement to access public health services.
- The constitutional entitlement to health plays a pivotal role in disrupting the harmful cycle of poverty and ill health, which would otherwise sustain inequality across various domains such as education, opportunities, wealth, and social mobility.
- Addressing the two key aspects of the UHC policy – enhancing primary healthcare and diminishing out-of-pocket expenses – requires dedicated focus.
Way Forward:
Addressing the Healthcare Needs of Urban Migrants:
- The first suggestion is to address the healthcare needs of urban migrants and initiate reforms in informal sectors.
- Given the significant increase in migration and mobility, there is a necessity for a paradigm shift in the vision of primary healthcare.
- It’s crucial to incorporate the aspect of mobility and the portability of healthcare access to facilitate the continuity of treatment.
Reducing Out-of-Pocket Expenses:
- The second recommendation is to streamline reimbursement processes to reduce out-of-pocket expenses.
- The structure of cash transfers and reimbursements within India’s public healthcare system needs adjustments to accommodate migrant and marginalized communities.
Establish Inclusive Health Systems:
The third suggestion is to establish inclusive health systems. Efforts should be made to integrate health management information system dashboards with both public and private healthcare systems, ensuring improved information systems that consider language barriers and the diversity present in urban areas.
Implementing Community-Based Primary Healthcare:
- The fourth recommendation involves implementing community-based primary healthcare in urban and peri-urban areas, alongside seamless referral systems.
- It is essential to promote the integration of services at the primary healthcare level, ensuring proper follow-up and adherence to healthcare protocols.
Conclusion:
A populace in good health is a populace empowered. A lower disease burden translates to stronger financial health for the country. In this election cycle, Universal Health Coverage (UHC) can represent a transformative proposition from political parties. Committing to invest in health systems and effectively implementing UHC requires political determination, significant financial commitment, and a clear, long-term vision. Establishing a coherent policy framework to consistently execute the national UHC policy across states is crucial for its success.
