Over the past few years, the once-obscure idea of universal health coverage (UHC) has blossomed into a movement embraced by leading establishments in global health. The Indian government has also come up with a national health policy. With most economies working towards an infrastructure which is better equipped to realize the vision of UHC, the role that private entities play in this must be understood closely. India as a nation presents a diverse set of demographics, which makes it difficult for any national government to look after the health of its people in its entirety. There have to be certain basic premises as to how the available funds are put to best use for healthcare. Moreover, the role of the government vis-à-vis the private initiatives is to be clearly defined, so that the efforts are complementary. For standardization of healthcare services and accessibility, there must be further deliberation on the role of the private sector into health systems and a broader perspective on how public and private sectors can work together to address the challenges of affordability, quality and accessibility of care. Today, the private sector acts as a vibrant force in the Indian healthcare industry with over 70 percent contribution in healthcare delivery.
India currently spends cumulatively 4.2 percent of its gross domestic product (GDP) on healthcare, with just 1.4 percent contribution by the government, which is among the lowest, globally. Even the projected government’s contribution by 2025 (at 2.5 percent) does not cut close with ground-level realities. Countries such as the UK, China and Indonesia lead the global statistics when it comes to public sector contribution. With an ever increasing scale, India is the fastest growing trillion-dollar economy and the sixth largest with a nominal GDP of USD 2.61 trillion. Now, we aspire to become the third largest economy worth USD 10 trillion by 2030. And, to achieve this goal, a healthy India also becomes a necessity as our non-communicable diseases (NCDs) burden is rising alarmingly and is estimated to cost around 2 percent of our GDP. With NCDs contributing to around 5.87 million (60 percent) of all deaths in India annually, the country’s burden of NCDs is escalating. Another challenge is that the onset of such diseases starts a decade earlier, at 45 years, in India, while most developed countries start having it at 55 years of age. The World Economic Forum Study says that the world will spend USD 30 trillion by 2030. In its essence, universal health coverage wants to ensure that citizens of our country obtain medical services they need sans any financial hardships while paying for them.
There are many connections between this goal and the state’s legal obligation to realize the human right to health. In the context of this goal, it is important to assess the private actors’ involvement in the health sector. For example, private actors may not always have the incentives to deal with externalities that affect the availability, accessibility, acceptability and quality of healthcare services; they may not be in a position to provide ‘public good’. India can show a way to the world by adopting cohesive collaboration for a new healthcare ecosystem. Private providers have been playing a pivotal role. However, the bigger partnerships with rational policy framework can take us to the next level to achieve the goal of ‘health for all’. Finally, affordability should not be sacrosanct. If India becomes a USD 10 trillion economy by 2030, then people will have more money. So, let the different sections of the population decide the services they want to avail based on their budget. In order to cater to the masses, we of course need a janata (mass) model, but, it must be remembered that ‘one size cannot fit all’.
The author Arvind Lal is managing director, Dr. Lal PathLabs. – Livemint