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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.