The ill health of the nation

The ill health of the nation: The National Health Accounts data for 2013-14 present fresh evidence that India continues to have a non-serious approach to the provision of universal health coverage to all its citizens. India’s...

Excerpts

"The National Health Accounts data for 2013-14 present fresh evidence that India continues to have a non-serious approach to the provision of universal health coverage to all its citizens. India’s health system is one of the most privatised in the world, poorly regulated and accessible only to those with income levels well above the average. All these attributes are, once again, strongly borne out by the NHA data, which lay bare the extremely low government spending on health which, at 1.15 per cent of GDP, compares poorly with even Sub-Saharan Africa. There, World Development Indicators say, the corresponding figure was 2.9 per cent six years ago. The share of State governments, which are largely responsible for provision of health care, in government health expenditure is estimated at 0.75 per cent of GDP. Evidently, a health policy that fails to pool the financial risk of illness at the population level results in impoverishing payments made out of personal funds — and the NHA figures confirm that despite rising government revenues, the bulk of Indian health spending, a staggering 64.2 per cent of health expenditure, is met by households out-of-pocket. That such OOP expenses declined by five percentage points over a decade is encouraging, but this is insignificant in comparison with the achievement in, say, Thailand, where 75 per cent of the population was brought under UHC in just one year."

My View

Universal healthcare

This refers to your editorial “The ill health of the nation” (The Hindu, August 31). It is a matter of shame that literacy and healthcare do not get the attention they deserve from the policy makers in India. The speech given by Singapore Deputy Prime Minister Tharman Shanmugaratnam at NITI Aayog in Delhi (his audience included Prime Minister Modi and several other dignitaries) should be an eye opener to all those who think that by improving GDP growth and giving an inflation target to Reserve bank of India, this country’s aim of ‘inclusive economic development’ comparable to emerging developing nations of the world can be achieved. Shanmugaratnam made specific reference to alarming levels of school drop-outs in India and terribly inadequate healthcare facilities here.
It is time we started monitoring efforts in literacy improvement and provision of healthcare by a reverse process of Aadhaar-linking. Grass-root level administrative limbs of the government, like district and taluka level administrations and local self-government bodies should be given the responsibility of linking every family in which a child of school-going age is there with a local school and all families with a local designated doctor or a primary health centre/hospital using Aadhaar number as identity-link. Thereafter, the burden of reporting inadequacy in infrastructure and monitoring progress in ensuring 100 per cent literacy and provision of need-based healthcare for all should be that of those agencies. Local MPs and MLAs should coordinate these efforts.

M G Warrier, Mumbai  


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