NEW DELHI, 27 JUNE: The issue of universal health coverage (UHC) will be discussed for the first time by the Sonia Gandhi-led National Advisory Council (NAC) tomorrow.
The UHC has been the agenda of the Union government and was part of the suggestions for the 12th five-year-plan. Tomorrow’s meeting comes two months after the working group of NAC on universal health care presented its final recommendations. All 12 members of the NAC, including tribal expert and sociologist Virginius Xaxa, who has replaced Aruna Roy after her exit, will be present.
The suggestions of the working group of NAC on universal health care, which consisted of Dr A K ShivKumar, Dr Mirai Chatterjee and Dr Mihir Shah, member of the Planning Commission, will be discussed at the meeting. Dr Chatterjee is currently associated with the Self Employed Women&’s Association (SEWA) as director of social security. Dr ShivKumar, an economist, is working as a consultant with the UNICEF. Both of them are also part of the governing body of the Public Health Foundation of India.
They would make a presentation to Mrs Gandhi and other NAC members on the modalities of implementing UHC. Dr Chatterjee said the government is committed to bringing reforms in the health care system.
“The recommendations which the working group has given are already being looked into by the Ministry of Health and Family Welfare and the Planning Commission. We are committed to providing healthcare for the common man. The first and foremost thing is that we must increase the public expenditure on health. Primary health services and secondary health services must be strengthened,” said Dr Chatterjee.
The recommendations of the working group cover financing for universal health coverage, urban health, piloting universal health coverage, community action among others. It suggested that a system of UHC should “absolve individuals of having to pay for medicines and diagnostics as well.”
On increasing public expenditure, the working group has recommended that the states should match the expenditure made by the Centre. “If this is achieved the expenditure of the Centre and the states on health would rise to 1.87 per cent of GDP at the end of the 12th five year plan,” it said.
Dr Chatterjee said the private sector should be involved in providing healthcare. “We have not ruled out the private sector in providing healthcare. If there are gaps in the public healthcare system, the private sector can be involved through contracting-in,” she said.
Emphasis has been laid in the recommendations on primary health care, immunisation and filling up vacancies at the primary health care centres. This according to the group will reduce infant mortality rate, maternal mortality rate and reduce anaemia.
The working group has also recommended creation of a public health cadre by states which at present is not there. It recommends providing free generic medicines to all in hospitals.
For regulation of health care, the committee has recommended establishment of National Health Regulatory and Development Authority, an autonomous and statutory body to oversee the quality of healthcare provided by both public and private personnel and organisations.
The recommendations say the universal health coverage schemes of the states should also include the middle class. “Strong emphasis should be on universality so that the vulnerable middle class is not left out,” said the recommendations.
Also it suggests setting up of Healthcare Social Enterprises. “Healthcare Social Enterprises would be an integrated network of primary, secondary and tertiary care which would be paid on capitation basis,” said the recommendations.
On the issue of insurance schemes, the group has suggested a hybrid model that will integrate the insurance system with the health system. The group has expressed confidence that it is possible to offer universal health insurance. “It is possible to offer almost universal health insurance for secondary and tertiary care with existing funding,” said the recommendations. Dr Chatterjee said the need to have universal health insurance can be done away with if the primary and secondary health care services are provided free.