Access, Quality and Cost are three major issues involved in providing efficient healthcare in India.
Access - India has less than 1 doctor per 1500 population, much less than WHO recommendation. The ratio is far worse in rural India.
Quality - According to a WHO report, more than 50% of 'doctors' in India do not have any medical qualification. Even corporate hospitals are criticised for money-mindedness & poor handling of patients.
Cost - According to WHO, the out of pocket expenditure in India is among the highest in developing countries. Less than 1.5% GDP is spent on Healthcare.
1) National Helath Policy(NHP), 2017 envisages comprehensive primary healthcare through Health and Wellness centres and availability of 2 beds per 1000 population.
2) Public health facilities at all three levels shall be expanded and private players should be roped in through contracts.
3) Penetration of Tele and online medicine, AYUSH, standardised treatments etc.
4) NHP, 2017 envisages regulatory standards for quality of healthcare. Patient feedback through "Mera Aspataal" initiative can improve quality in public hospitals.
5) Karnataka's latest Private Establishment Bill which fixes responsibility for medical negligence can be adopted in other states.
6) Owing to poor access, quacks in rural areas shall atleast be trained as RMPs to improve their quality of service.-
7) NHP, 2017 provides for free medicines, diagnostic, emergency and essential healthcare services in public hospitals and to rise public expenditure to 2% GDP.
8) An empowered autonomous authority can be formed by combining all central, state and employer insurance schemes which purchases required services using tax pooling through competitive bidding. Large risk pool ensures cross-subsidisation and minimisation of out of pocket expenditure.
CONCLUSION :A comprehensive way to address all three issues is through Universal health Coverage(UHC), inspired from Thailand's UHC model. As more developing countries are adopting UHC, India shall join the queue to achive the SDG 3 of ensuring healthy lives for all.
