IMA calls for tax-funded universal health coverage

The High-Level Expert Group (HLEG) on Universal Health Coverage (UHC) was constituted by the Planning Commission of India in October 2010, under the chairmanship of Prof K Srinath Reddy, with the mandate of developing a framework for providing easily accessible and affordable health care to all Indians. HLEG recognised that it is possible for India, even within the financial resources available to it, to offer UHC to every citizen. Echoing the same point, the National President of Indian Medical Association (IMA) Dr R V Asokan said, “UHC entails ensuring all people have access to quality health services including prevention, promotion, treatment, rehabilitation, and palliation without incurring financial hardship. It should be tax-funded without the involvement of any middleman like insurance industries. If this happens, a lot of issues related to healthcare sector would be resolved.” Dr R V Asokan was in Nagpur to grace the installation of Dr Manjusha Giri-led new team of IMA, Nagpur branch on Sunday.

While talking to ‘The Hitavada’, Dr Asokan stated, “We need to emphasise more on healthcare sector. Our health investment is stagnant at 1.1 per cent of the Gross Domestic Product (GDP) since long. The lack of funding is leading to poor infrastructure and lack of human resources in hospitals especially in public sector or in Government hospitals. The HLEG had recommended that the share of health sector should be 2.5% of the GDP. Presently, we are spending Rs 3 lakh crore but our expenditure of health sector is Rs 12 lakh crore.” Dr Asokan put a very valid point about public sector healthcare. According to him, investment should be more in public sector or Government hospitals. “NITI Aayog should guide Government to focus more on Government set-ups. If we take our performance during coronavirus pandemic, we have greater degree of success than even the western countries. We could achieve success all because of public sector. Ordinary citizen can have access in public sector hospitals. NITI Aayog should recommend Government to appoint more doctors in GMCHs.”

Criticising insurance system in health care, Dr Asokan said, “Insurance is a failed model even in a 20-trillion economy like USA. Government should provide health care directly to common man without middleman. Insurance industry has nothing to do with health. It is helping only the corporate hospitals. Their say in Government policy is rising and medical fraternity is losing leadership. Except a few doctor-run hospitals, corporates are running hospitals everywhere with doctors becoming employees. This is not a good sign for Indian healthcare system. Doctors-run hospitals have no target, they are cost-effective, their approach towards patient-care is more humane.”

Through Pradhan Mantri Jana Aarogya Yojna, Government claims to cover a lot of people. But its major share goes to Government hospitals. Dr Asokan feels it needs restructuring so that the private hospitals can also get the benefit. The healthcare in Government sector is already free so there is no point in providing PMJAY scheme there. It should be only through private sector. Insurance companies’ share is 10 to 15 per cent, a poor way of funding Government hospitals.” Raising his voice against the violence against doctors, Dr Asokan said, “In case of obstetrician, sex determination is considered a culpable offence. Instead lets have sex determination. If it is a girl, then follow the pregnancy, ensure the safety of that girl child, maintain the record. If something happens to the girl child, then investigate the matter and take action against the culprit. This particular aspect needs a relook.”

‘Respiratory medicine should be part of medical curriculum’
Former President of Indian Chest Society and Secretary Dr Sundeep Salvi and Dr Rajesh Swarnakar are striving hard to get Respiratory Medicine included in the curriculum of MBBS. Responding to it, Indian Medical Association too is constantly working on it. When asked about it, Dr R V Asokan, National President of IMA made it clear, “We have passed a resolution in Chennai last week to this effect. We want it to be a part of the curriculum. Prime Minister Narendra Modi has already urged that Tuberculosis (TB) should be eliminated by 2025. Against that backdrop, Respiratory Medicine assumes importance. We are for inclusion of Respiratory Medicine, Emergency Medicine and Rehabilitation Medicine in MBBS curriculum.” The Hitavada