Universal Health Coverage India – Can it be a reality?

Universal Health Coverage India - Can it be a reality?

universal health coverage indiaUHC is an acronym for Universal Health Coverage. As the name suggests, UHC is a service works for health in our country. UHC for India is a universal service and is lifelong based on the citizens being resident of the country.

Universal Health Coverage

During the 12th Plan Period, in the year 2012, “Universal Health Coverage for All” was envisaged making it mandatory for the state to make available sufficient food, appropriate medical care, safe drinking water, proper sanitation, education and health-related information for good health. A framework was developed to provide reasonably priced and easily available healthcare services to all Indians.

Under UHC, regardless of income level, social status, gender, caste or religion, to affordable, accountable, appropriate health services of assured quality as well as public health services addressing the wider determinants of health delivered to individuals and populations is provided.

In simpler words, under “Universal Coverage” all the citizens of India irrespective of their economic, social or cultural status have equal access to the full range of affordable quality health services, including prevention, treatment, hospital care, and pain control. The quality of appropriate and packaged health services will be defined in a published package of services and benefits. An additional financial means to shield people from spiraling medical expenditure.

Universal Health Coverage India

For this service, the Indian Government is the sponsor and enabler, although not necessarily the only provider, of health and related services. With “Universal Health Coverage” Indian government has aimed to provide its citizens with quality and affordable health care facilities irrespective of financial stature. Additionally, the government is working towards improving the quality of health care at hospitals and health care institutions.

How does Universal Health Coverage Work?

Through UHC, all the costs are shared among the entire population through prepayment and risk-pooling, rather than cost shouldered by the sick. Access is based on need and nowhere related to the ability to pay. In other words, let me explain a bit further, facilities of healthcare under UHC will be funded by the Government of India through taxes in addition to augmented spending on public health to pay for the health services provided to its citizens. With the focus on going “cashless”, the government is promoting the plan such that patients will not be charged user fees by healthcare providers for the services delivered. The framework entails setting up Public Health Service Cadres at the national and state level. Also, there are provisions to set up a special state-level Health Systems Management Cadre in order to make the system’s foundation self-sufficient.

Universal Health Coverage Benefits

The UHC benefits at the national level include improved health of the population, quality healthcare services, greater productivity, increased jobs, efficient and greater equity, accountable and transparent health system, and financial protection.  The coverage framework very clearly considers the fact that there is no binding on citizens to discontinue their existing private insurance coverage for medical treatment. They can even opt for new ones for diseases not covered under UHC. But the private insurance carriers will have to adjust coverage amount to include benefits being not offered by UHC.

UHC Budget 2018

In 2018, the budget allocated was Rs.1,200 crore for converting 150,000 sub-centers into active delivery points for comprehensive primary health services.

UHC Principles

According to the official website, the following ten principles have guided the formulation of UHC in India:

  • Equity
  • Non-exclusion and non-discrimination
  • Universality
  • Comprehensive care that is rational and of good quality
  • Community participation
  • Financial protection
  • Patient choice, portability, and continuity of care.
  • Consolidated and strengthened public health provisioning
  • Protection of patients’ rights that guarantee appropriateness of care
  • Accountability and transparency
  • Putting health in people’s hands

How to access quality health benefits under the umbrella of Universal Health Coverage?

Every citizen of India needs to get registered with UHC in order to avail the services under UHC. An IT-enabled National Health Entitlement Card (NHEC) smart card is issued to the registered citizen. The smart card has few benefits such as storing the individual’s medical history, not location dependent and enabling of cashless transactions.

It is provisioned in Universal Health Coverage, that a citizen, at the time of requirement, can make a choice between government hospital as well as contracted-in private hospitals which are on the panel.  Also, citizens can procure medications free of cost at all facilities but there is condition – they should be part of the published UHC package.

Universal Health Coverage PDF

The UHC PDF issued by Planning Commission of India can be found here. In 2016, India’s Rank at Global Healthcare Access and Quality(HAQ) was 145 among 195 countries.

Will ‘Ayushman Bharat Yojana’ subsequently lead to ‘Universal Health Coverage’ in India?

#AyushmanBharatYojana was declared by Modi government in the Union budget 2018-19 of the Government of India so as to carry forward the concept of National Health Policy 2017 (NHP-2017) which in turn is aligned with UHC. The Ayushman Bharat Yojana comprises majorly of two parts namely – “Health and Wellness Centers” and “Pradhan Mantri Rashtriya Swasthya Suraksha Mission”. The aim of #AyushmanBharatYojana is to provide easy affordable access of primary, secondary and tertiary healthcare services to poor & vulnerable masses of India. If the ambitious #AyushmanBharatYojana undergoes full implementation followed up by additional interventions, it can certainly prove a game changer in the healthcare system propelling India towards UHC.

Ayushman-BharatThe cons of the program will take time to iron out looking at the implementation level with respect to the size of India. But the pros of Ayushman Bharat scheme need to be highlighted as it is world’s largest and most ambitious healthcare protection program which provides support to the most deprived portion of India’s population and engages private insurance players. The road to UHC is definitely difficult looking at the breadth of implementation but at least a step in the form of #AyushmanBharatYojana has been taken.

But do keep in mind that the principles of AyushmanBharatYojana and UHC cannot be only achieved by government efforts. A middle path wherein public healthcare system can be constructed rapidly with the help of private healthcare providers funded by the government can be thought of. Government and private sector are pouring money on secondary and tertiary levels of healthcare but the focus should be to build a viable and low-cost primary healthcare as it forms the primary component of any successful and affordable healthcare system.

We hope that this article regarding UHC was useful to you. Stay tuned to The Telescope for the latest updates and news.

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