Dr.Thomas Fuller in his book Gnomologia said, “Health is not valued till sickness comes.” This has also been the approach of public healthcare in India over the years which had its focus on curing the diseases than its prevention. But all that is set to change with the recently approved new national health policy where the government has proposed to increase public health spending to 2.5 per cent of the Gross Domestic Product (GDP) from the current 1.4 per cent in a time-bound manner. The policy is “patient-centric” and has put emphasis on restructuring of the public health system.
For a country where 21.9 per cent of its population lives below the poverty line, accessibility to healthcare has remained one of its biggest challenges. The situation was exacerbated by the fact that for the last 15 years there has been no change in the country’s health policy which has further widened the rich-poor divide. Lack of infrastructure, insufficient funds and understaffed hospitals are some of the problems under which the Indian healthcare sector is reeling.
The Indian government has till now been spending only 30 per cent of the country’s total healthcare budget on primary healthcare. Over 60 per cent of the healthcare expenditure in India is categorized as “out of pocket” expenditure incurred by individuals. The figures point to the dismal plight of a nation that has been battling the twin epidemics of communicable diseases and chronic degenerative diseases without a plan to combat it in the long run.
The new health policy aims to correct this inconsistency by placing the thrust on “prevention and health promotion”. In a commendable step, it has advocated allocating two-thirds of resources to primary care. It has also taken into consideration the fact that 70 per cent of the country’s population still lives in rural areas with accessibility being the biggest of all concerns. To ease the prevalent situation, two beds per 1000 population will be distributed in a manner which will makes access easy for all.
Provisions have also been made in the bill to provide free drugs, free diagnostics and free emergency and essential healthcare services in all public hospitals. In a country where only five per cent of the population is covered by insurance policies according to a report by the National Commission, this will be a significant step in providing timely care well as in reducing the commercialization of healthcare.
The other important goals of the policy are to increase the life expectancy at birth from 67.5 years at present to 70 years by 2025 and a reduction in the total fertility rate to 2.1 from the current 2.3 by 2025. It also aims to reduce the under-five mortality rate from current rate of 45 per thousand births to 23 by 2025, maternal mortality rates from 174 per 100,000 to 100 by 2020 and reduce infant mortality rate to 28 by 2019 from 39 at present. The policy has also stated as its objective the complete elimination of leprosy by 2018, kala-azar by 2017 and lymphatic filariasis in endemic pockets by 2017.
Another noteworthy aspect is the call for a “stronger partnership” between the public and private sectors to achieve national health goals. In a stark contrast to the bleak state of affairs of the public sector healthcare, the private healthcare industry in India is expected to grow to become a US $280 billion industry by 2020. This is an advantage that the government can leverage to bring in modernization of the existing infrastructure.
The focus on alternative medicines and yoga in disease prevention is also significant as it will see public healthcare heading towards a more holistic approach. The government would have well fallen short of making healthcare a fundamental right but the new health policy has all the provisions to revolutionize public healthcare in India and make it all inclusive. Three states in India have already pioneered public healthcare and has paved the way for the nation to bring about lasting reforms.
The first state is Rajasthan which has reduced its poverty level by 10 per cent with a simple step by providing drugs and basic diagnostics free of cost to the general public. The next is Tamil Nadu which provides 400 drugs free of cost in its government dispensaries and the third is Kerala which is the first state in the country to provide cancer treatment free of cost and provide all the BPL families with insurance of Rs 2 lakh. Through the new national health policy the Centre has finally shown the political will give the citizens a healthy and wealthy future.