A Booster Shot for Health

Context: Health and economy should be closely intertwined for boosting economic growth.

Problems associated with Health Sector in India

• Low public expenditure on health: At present, it is only 1.3 % of Gross Domestic Product (GDP).
• High out-of-pocket expenditure: around 58 %. 
• Inefficacy of insurance: Salary deductions (Labour taxes) for insurance purchase are not feasible since much of the workforce is in the informal sector.

Ways to Improve Health Sector in India

• Increase public expenditure on health: to 2.5 % of GDP by 2025, from the present 1.3 % (20-25 % increase in the overall allocation to health is needed.)
  • Centre-state collaboration: The states should increase their allocations for health while the Centre should set the pace.
  • Raise revenue for the health sector: Through higher taxes on tobacco products, ultra-processed foods and beverages, alcohol and luxury vehicles.
• Healthcare targeting and increasing accessibility:
  • Reduce out-of-pocket expenditure: to 15-20 % recommended by the World Bank and the World Health Organisation. (using programmes of universal health coverage)
  • Equal importance to short (pandemic) and long-term needs (sustainability): For assurance of sustained efficiency and equity in health services.
    • Through increased allocations for both rural and urban primary care.
    • Activating Urban Health Mission that enhances cold storage.
  • Focus more on Primary healthcare: As it serves the whole population, offers the largest package of services and is cost-optimising.
    • The commitment made by the National Health Mission to allocate two-thirds of health financing to primary care should be realised.
  • Link primary, secondary and tertiary levels of care: For enabling comprehensive, continuous and connected care for many chronic diseases.
  • Cover “missing middle” in Government programmes:
    • Linking Pradhan Mantri Jan Arogya Yojana with the National Health Mission can provide coverage for out-patient care.
    • Focus on elderly care, disability services and mental health.
• Healthcare Infrastructure Development:
  • Support Surveillance systems, laboratory capacity and upgrade hospitals.
  • Develop health workforce: By expansion of a multi-layered, multi-skilled health workforce through investments in training institutions (in partnership with states)
    • Multi-disciplinary expertise shall be fostered by expanding training institutions and creating public health cadres (as recommended by National Health Policy 2017).
  • Allocate more funds for Health research: especially in the area of implementation research to ensure that more money for health translates to more health for the money.
  • Incentivise Health technologies: To enhance the effectiveness and equity of health services, through appropriate and affordable innovations.
  • Enhance quantity and quality of medical products: For this “Make in India” must support domestic pharmaceutical, vaccine and medical equipment makers.