Contents

1. Universal Healthcare Coverage Day

UNIVERSAL HEALTHCARE COVERAGE DAY

Focus: GS 2 ;Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.

Why in News?

Universal Healthcare Coverage Day celebrated in Health Ministry

About Universal Health Coverage Day (UHCD)

• The Universal health coverage means that all people have access to the health services they need, when and where they need them, without financial hardship.
• It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
• Currently, at least half of the people in the world do not receive the health services they need.
• About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health.

• To make health for all a reality, we need individuals and communities who have access to high quality health services so that they take care of their own health and the health of their families, skilled health workers providing quality, people-centered care and policy-makers committed to investing in universal health coverage.
• The Universal health coverage should be based on strong, people-centered primary health care.
• The Good health systems are rooted in the communities they serve, they focus not only on preventing and treating disease and illness, but also on helping to improve well-being and quality of life.

Above image of Pros and Cons of Universal Healthcare.

The Objectives of Universal Health Coverage (UHC)

• The Equity in access to health services for everyone who needs services should get them, not only those who can pay for them.
• The quality of health services should be good enough to improve the health of those receiving services and
• The People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm.

The Time line regarding Universal Health Coverage (UHC)

• In 1977 the WHO set the target of Health for All.
• In 2000 the MDG was formulated with the target of achievement set for 2015.
• In 2015 the SDG was formulated with the target to be achieved by 2030.
• The SDG 3 includes a target to “achieve universal health coverage (UHC), including financial risk protection, access to quality essential health care services, and access to safe, effective, quality, and affordable essential medicines and vaccines for all.”.

The Problems Present in  Indian Health Sector

• The India has the world’s second-largest population, rising from 760 million in 1985 to an estimated 1.3 billion in 2015 and the existing healthcare infrastructure is not enough to meet the needs of the population.
• The central and state governments do offer universal healthcare services and free treatment and essential drugs at government hospitals. However, the hospitals are, understaffed and under-financed, forcing patients to visit private medical practitioners and hospitals.
• The Qualified healthcare providers are in short supply nationally and those available are mal-distributed, with marked density differences across regions.
• The Majority of healthcare professionals happen to be concentrated in urban areas where consumers have higher paying power, leaving rural areas underserved.
• The India has one of the lowest per capita healthcare expenditures in the world.
• The Government contribution to insurance stands at roughly 32 percent, as opposed to 83.5 percent in the UK.
• The high out-of-pocket expenses in India stem from the fact that 76 percent of Indians do not have health insurance.
• The Healthcare induced financial distress is a leading cause of suicide among farmers.

        The Challenges in implementation of Universal Health Coverage (UHC)

• The Biggest challenge remains in identifying what services are to be universally provided to begin with and what level of financial protection is considered acceptable.
• The offering same set of services to the entire population is not economically feasible and demands huge resource mobilization.
• The Prioritizing certain services to the poor and vulnerable sections to ensure both access and affordability, while leaving the rest of the population for coverage at a later stage is also not a good option as it essentially leaves out the tenet of universality.
• Even countries which follow an insurance model have a high level of public funding to support several health services.
• The mandated contributory insurance model will not work in India which has over 90 per cent of the workforce in the informal sector.

The Constitutional Provisions in Indian HealthCare Systems

• Given no explicit recognition of the Right to Health or healthcare under the Constitution, the Supreme Court of India in Bandhua Mukti Morcha v Union of India & Ors interpreted the right to health under Article 21 which guarantees the right to life.
• The most provisions related to health are in Part-IV (Directive Principles), These are as follows:-
• The Article 38 says that the state will secure a social order for the promotion of welfare of the people. Providing affordable healthcare is one of the ways to promote welfare.
• The Article 39(e) calls the state to make sure that health and strength of workers, men and women, and the tender age of children are not abused.
• The Article 41 imposes duty on state to provide public assistance in cases of unemployment, old age, sickness and disablement etc.
• The Article 42 makes provision to protect the health of infant and mother by maternity benefit.
• The Article 47 make it duty of the state to improve public health, securing of justice, human condition of works, extension of sickness, old age, disablement and maternity benefits and also contemplated. Further, State’s duty includes prohibition of consumption of intoxicating drinking and drugs are injurious to health.
• The Article 48A ensures that State shall Endeavour to protect and impose the pollution free environment for good health.
• Apart from DPSP, some other provisions related to health fall in 11th schedule and 12th schedule as subjects of Panchayats and Municipalities respectively. These include drinking water, health and sanitation, family welfare, women and child development, social welfare etc.
• The above description makes it clear that most provisions related to health fall in DPSP in the constitution.
• They are non-justifiable and no person can claim for non-fulfilling of these directives.
• However, Judiciary has widely interpreted the scope of Right to Health under Article 21 (right to life) and has thus established right to health as an implied fundamental right.

        The Universal Health Coverage in India and Government Initiatives

• The India has made rapid strides towards increasing access to health services in the past few years through a number of initiatives.
• The National Rural Health Mission (2005),it seeks to provide equitable, affordable and quality health care to the rural population, especially the vulnerable groups.
• The main programmatic components include Health System Strengthening in rural and urban areas the Reproductive-Maternal- Neonatal-Child and Adolescent Health (RMNCH+A), and Communicable and Non-Communicable Diseases.
• The Rashtriya Swasthya Bima Yojna (2008), it covers the cost of secondary-level hospitalization.
• The National Program for Prevention and Control of Cancer, Diabetes, CVDs and Stroke (NPPCDS).
• The National Urban health Mission. It provides health care to urban population. Later NRHM and NUHM were clubbed into National Health Mission
• In addition, there are a number of state-specific schemes. Some involve running free diagnostics facilities and offering free medicines; others are government-funded health insurance schemes in several states.
• The Ayushman Bharat , the Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) launched on 23rd September 2018 which helps in to boost healthcare service in India.

      Conclusion

• The long road map has to be there to achieve Universal healthcare in Indian system, the loopholes and bottle necks in the present laws has to be closed to achieve the SDG goals i.e. Healthcare for All by 2030.
• The Government funded programme should ensure that financial barriers should not stop access to needed advanced care, which is the basic right of the humans to have health facility along with the regular needs like food, shelter, clothes etc.,
• The Right to health to be recognized as a fundamental right in India for better boost from the state and center to address the basic need of the healthcare system.
• The Government i.e. center and states has to coordinate proper for better implementation of schemes along with the support from the private and institutions for targeted goals to achieve.