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Topic : Healthcare Spending in India: Need for Increased Public Investment
GS-2 Mains : Health
Revision Notes
The Problem:
- India’s public health spending is low compared to other countries.
- Bhutan spends 2.5 times more.
- Sri Lanka spends 3 times more.
- BRICS nations spend 14-15 times more.
- The Union Government’s health spending has decreased post-pandemic.
- Share of Union spending transferred to States has declined significantly:
- FY14: 75.9%
- FY24 (BE): 43% (new low)
Impact:
- This trend centralizes financial resources while healthcare falls largely under States’ domain.
- Funding for the National Health Mission (NHM), a crucial central initiative, has stagnated or decreased in recent years.
India’s Healthcare System:
- Public sector: Limited secondary and tertiary care, focuses on basic care through Primary Healthcare Centers (PHCs) in rural areas.
- Private sector: Provides most secondary, tertiary, and quaternary care, concentrated in major cities.
The Need:
- Increased public expenditure on healthcare, especially at the Central level.
- More support for initiatives like the NHM to strengthen public healthcare delivery.
Public Healthcare Financing in India : Structure
- States manage public hospitals and clinics.
- Ministry of Health & Family Welfare sets policy and provides support:
- Funds states for public health facilities.
- Runs national institutes (AIIMS) and UT facilities (Delhi).
- Oversees public health schemes & medical education.
- Conducts medical research.
Concerns:
- Low public spending leads to:
- Inadequate health infrastructure (staff & facilities).
- Limited access, especially in rural areas.
- Disparity between urban & rural health.
- Neglect of preventive and primary care.
- Higher disease burden.
- Increased out-of-pocket expenses for citizens.
Recent Initiatives for Healthcare Growth in India
- Digital Health Infrastructure: National Digital Health Mission (NDHM) launched in 2020 to create a digital health ecosystem with citizen health IDs.
- Health Insurance: Ayushman Bharat PMJAY (2018) offers financial protection for hospital care to over 100 million families.
- Preventive Care Focus: National Health Policy 2017 emphasizes preventive and promotive healthcare through Health and Wellness Centers (HWCs).
- Strengthening Tertiary Care: Pradhan Mantri Swasthya Suraksha Yojana (PMSSY) expands AIIMS institutions and upgrades medical colleges.
- Boosting R&D: Government initiatives support research and development in vaccines, drugs, and medical technologies.
- Medical Education Reforms: National Medical Commission (NMC) Act (2019) replaces the Medical Council of India (MCI) for improved transparency and accountability in medical education.
- Affordable Medicines: Jan Aushadhi Scheme provides quality generic medicines at lower prices through Jan Aushadhi Kendras.