Friday, February 2, 2018

ModiCare: A step towards the holy grail of Universal Health Coverage



Budget 2018: National Health Protection Scheme - A smart move towards Universal Health Coverage

In an earlier article on five strategies to wake up the moribund Indian Public Healthcare system 1, 4, the first strategy recommended by yours truly was to “declare health as a fundamental right and to provide universal Healthcare”.  The excerpts are as follows:

First Strategic Intervention – Comments And Suggestion Of The Author: 1
India is today a $2.3 trillion economy and growing, it is the right time for the government to go big, allocate 3 per cent or more of GDP for health, “declare health as a fundamental right” and provide – Universal Health Coverage (UHC). It is time to take charge and go for big audacious goals. Strong governments can pull through the impossible and achieve results beyond the bounds of human imagination due to collective efforts and the goodwill of people. This is actually Modi’s moment in history to seize and leave an indelible mark, more importantly; it is the right thing to do 1.
UHC, in its simplest definition means, access to quality, effective and affordable health services for all, without imposing financial burden. This can be achieved through various methods using government and private sector expertise and the costs borne by insurance premium paid by the government on behalf of citizens and other methods feasible. All citizens should be entitled to a comprehensive package of healthcare services, and have access to public health and accredited private facilities for attaining services such as diagnostics, medicine, vaccines or surgeries as an entitlement, without having to pay at the point of use 1.

Today the union Budget of 2018-19 took a major step towards Universal health Coverage albeit it did not declare Health as a fundamental right.

In the current Budget Government of India (GOI) has moved a step forward  towards providing Universal Health Coverage  under National Health Protection Scheme (NHPS), the GOI will provide health insurance worth Rs 5 lakh to 10 crore poor families across India, approximately covering  50 crore people out of 130 crore population with a program almost equal to Universal Health Coverage. It will be the largest government-funded health insurance scheme to be implemented anywhere in the world as per available numbers and statistics.

Under NHPS, as expected poor citizens of India, will get medical treatment in secondary and tertiary hospitals free of cost covered by GOI funded Health Insurance. This will be a boon to poor people as “out of pocket payment” was the single most common cause sudden emergent financial crisis among rural folk and urban poor of India 2. Each year, as per available data, more than 40 million people in India, mostly rural folk and urban poor are impoverished, get entangled in financial crisis and run into massive debts to access secondary/tertiary/quaternary care in India 3, 4. This flagship program although not universal, is still welcome.

As per available information, GOI in association with the states will pay a premium of Rs 1000 - 1200 to achieve a cover of Rs 5 lakhs per family per year. This year GOI has already committed Rs 4000 crores and may increase allocation if required.

In addition to the above, GOI will be setting up 1.5 lakh health and wellness centres or community healthcare clinics across India under Bharat Ayushman Programme. Under this plan, these 1.5 lakh health centres are a means to “bring healthcare closer home”, to provide healthcare support for non-communicable diseases, maternal and childcare services, along with free drugs and diagnosis. GOI is allotting Rs 1,200 crore for this programme and said it will ask private enterprises to join the programme as part of corporate social responsibility (CSR) initiatives. 

This flagship primary care program needs to be analysed with data available on Non Communicable Diseases (NCDs) to understand how important this initiative is to nation and our healthcare policy. Successive governments had been asinine in their approach using fiscal prudence, not allocating adequate funds and policy importance to NCDs 4, 5, 6. NCDs along with accidents today account for nearly 52% of deaths and effectuate a loss of 6% to our GDP, as economically productive citizens die prematurely 4, 5. This program is trying to address the growing burden of NCDs and also will go a long way in reducing burden on our tertiary centres. Since drugs are made available free of cost, it will ensure compliance of patients and disease progression along with its complications is stalled 4. This will ensure better economic productivity of individuals and also better GDP numbers for the nation. This confirms to the second strategy recommended by yours truly - excerpts as below:

Second Strategic Intervention – Establishment Of National Drug Procurement Policy 1:
The “Jinx of 70”, it is well established that 70 per cent of healthcare expenses are due to cost of medicines. Right to health and universal health coverage cannot be achieved without access to affordable essential drugs on a regular and viable basis. Millions of Indians could access better care, if government decides to procure generic medicines in bulk and distribute them free of cost at public health facilities. The government should establish a national drug procurement and disbursal policy with mandate to procure and provide generic medicine, surgical implants, stents, devices, suture goods etc..., to all public and private institutions participating in UHC across the country. Distribution of free medicines and treatment accessories through public healthcare systems helps increase citizens trust in our public healthcare system and in the government of the day 1.

Although Bharat Ayushman Programme does not completely address, much required Drug policy; it along with Jan Aushadhi Scheme should be able to complement NHPS to move closer towards the sought after goal of Universal Health Coverage.

Bharat Ayushman Programme is also in sync with a part of recommended fourth Strategy where Primary care and prevention is accorded more importance than say for tertiary care with curative bias. Excerpts:

Fourth Strategic Intervention – Focus On Impact Areas In Healthcare:
Availability and accessibility of primary care in the time and place of need especially rural areas leaves an impact, it also allows the person to suffer minimum in terms of illness and also economic losses.

Allotting Rs 600 crore at the rate of Rs 500 for every TB patient every month, to provide nutritional support displays the sincere thought process of GOI in trying to reduce disease burden on its citizens. TB is notoriously difficult disease to cure and especially so when nutritional status of patient is bad.
Government of India, has committed itself to open 24 new medical colleges including upgrading a few existing colleges and ensure there is at least one government medical college in every state. This again confirms to recommendations from another article of mine regarding medical education and regulation of practice 10.

Overall, this budget of 2018-19 is clearly path-breaking for sheer size, coverage and amount committed per family almost embracing the holy grail of Universal Health Coverage. This along with other measures (like guaranteed minimum income to be rolled out by some states 7, 8, 9) ushers India firmly in the next generation of social security as India moves aggressively from a progressive developing economy to a developed economy.

References
1)      Five Strategic Interventions Modi Can Make To Give India A Far, Far Better Healthcare System https://swarajyamag.com/ideas/five-strategic-interventions-modi-can-make-to-give-india-a-far-far-better-healthcare-system

2)      Trends in catastrophic health expenditure in India: 1993 to 2014 http://www.who.int/bulletin/volumes/96/1/17-191759/en/


3)      Marten R, McIntyre D, Travassos C, Shishkin S, Longde W, Reddy et al. An assessment of progress towards universal health coverage in Brazil, Russia, India, China & South Africa (BRICS). Lancet 2014; 384: 2164-71).

4)      India’s Public Healthcare System Needs Urgent Overhaul: Are Those In Authority Listening? https://swarajyamag.com/ideas/indias-public-healthcare-system-needs-urgent-overhaul-are-those-in-authority-listening


5)      WHO country cooperation strategy at a glance India – 2013:  http://www.who.int/countryfocus/cooperation_strategy/ccsbrief_ind_en.pdf

6)      Burden of NCDs policies and programmes for prevention and control of NCDs in India. Indian J Community Medicine 2011; 36 (suppl 1): S7-12).




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