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Why Modicare may be poor for India's health

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Dinesh C Sharma
Dinesh C SharmaFeb 13, 2018 | 13:26

Why Modicare may be poor for India's health

In the past few weeks, many new policies related to the health sector have been announced, the foremost being the National Health Protection Scheme unveiled in the Budget. Though details of this scheme have not yet been revealed, it will be a government-funded insurance plan to cover hospitalisation costs at secondary and tertiary care levels for poor families.

The National Medical Council (NMC) Bill, aimed at bringing in a new medical regulatory authority, is also being reviewed by Parliament. Doctors have taken to the street against this move. Another health-related initiative is the draft of the new pharmaceutical policy.

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Amidst all this, the Niti Aayog has issued a Health Index that ranks the performance of states in the health sector based on indicators like total fertility rate, maternal mortality rate, status of health personnel, etc, but overlooks crucial indicators like public investment in health.

It appears the government and the institutions concerned are treating all these steps in isolation. This amounts to a piecemeal approach to health. We need a comprehensive blueprint for the overhaul of the health sector.

Take, for instance, the health protection scheme. In the absence of a policy format and clear objectives, any such "insurance only" scheme may not yield desired results and prove to be counter-productive like similar schemes implemented earlier by Union and state governments. Most such schemes have led to a rise in unnecessary procedures and malpractices, and not contributed to better health outcomes.

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High incidence of costly procedures like stenting, heart surgeries and hysterectomies have been reported in states that funded health insurance. Shifting the government’s responsibility to the private sector without necessary quality and pricing checks would be dangerous. The Clinical Establishment Act — which most states have not implemented — and the NMC Bill, which is pending in the Parliament, are supposed to address these issues.

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Another interrelated issue is the drug policy. India is fast losing its advantage of cheap drugs, as the domestic drug industry is becoming dependent on China for the supply of bulk drugs for manufacturing even essential medicines because we have systematically neglected public bulk drug firms.

At a time when the world is making a gradual shift to Universal Health Coverage (UHC), we are moving towards a private sector cum-insurance-led health system. UHC means providing a minimum set of services for all citizens. For this, countries need to strengthen their health systems and involve private sector wherever necessary.

The UHC approach in India is visible in the provision of free ART (Antiretroviral therapy) to people with HIV, free medication to TB patients and the neighbourhood clinic scheme in Delhi. All these are government-led schemes but involve private providers. If UHC is the goal, then it can’t be achieved via insurance alone. We need to strengthen primary care for all. There is no substitute for greater public investment in the health sector.

(Courtesy of Mail Today)

Last updated: February 13, 2018 | 13:26
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