Universal Health Coverage for India – Insurance, Medicines and human resources

The report of the High Level Experts Group (HLEG) instituted by the Planning Commission to provide Universal Health Coverage for India has many key features that need extensive debate. Disappointingly, such discussions are not taking place, at the level of political parties, Trade Unions, Civil Society organisations and even the media.

Most Indians cannot afford the drugs and formulations now being sold, because they must pay out-of-pocket

Most Indians cannot afford the drugs and formulations now being sold, because they must pay out-of-pocket

The Hindu has been taking particular aspects of the report and commenting on them. The newspaper has published two leader pieces so far, on the macro issue of how to fund a system of universal health care, and on making essential medicines free for everyone.  They are here and here.  The report of the HLEG is here.

The HLEG, headed by Dr. K. Srinath Reddy, cardiologist and prime mover of the Public Health Foundation of India, has provided a major resource in terms of the analysis of present day health coverage in India, the massive out-of-pocket spending incurred by Indians, health expenditures pushing millions into poverty and the overall debilitating effect this situation has on the country’s economy.

India has among the lowest public expenditures in the world on health care, and the issue of universalisation of health care through social protection is not on the agenda of any major political party.  The situation is confounded by the advent of neo-liberal economic policies in 1991, and the ascent of for-profit health institutions in parallel with the withdrawal of the State in real terms. The not-for-profit health care sector that has many well-known institutions is also on the decline, while private health insurance is exerting pressure on policy against a change in the status quo. This is manifested in the form of lack of public investment.

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