Universal Health Coverage is the Need of the Hour or Not?

During the lockdown due to the worldwide pandemic, there were surge of news in newspaper, news channels, social media related to the lack of medical and health care system services. People are dying because of the limited capacity of hospitals and medical services too. One thing came into my mind is that what is the possible solution to this problem?

Is universal health coverage is the right approach?

Before going to any conclusion let us understand the possible outcomes and challenges of universal health coverage.

The very first thing is why do we need universal health coverage?

The ancient phrase says that “A healthy mind lives in a healthy body. It is true that the development of a nation depends on its people as an asset and if people are healthy that nation grows. The development of a nation is a reflection of its social infrastructure, health and education. Keeping in mind the importance of health the policy makers drafted the health policy, which envisages universal health coverage (UHC) for the citizen.

The draft new policy considers health as a fundamental right. It may be said that right to health is a logical extension of article 21 same as education and legal services. Although this is the new policy draft but our constitution makers 70 years ago understood health as a basic right and need, that’s why we see the “Directive Principles of State Policy (DPSP)” (Article 36 to 51).

During the nationwide lockdown and the in this challenging period of Covid-19 pandemic one thing is very clear that India needs to spent more on its health infrastructure to improve the health services for the people. Although this approach of providing health care services in India is very relevant but there are some challenges to be addressed too.

Inclusiveness is the sole idea of our law makers and the health system inclusiveness needs to encompass the schedule tribes and casts because of the marginalization of these communities from the social fabric, and these communities do not enjoy the social benefits provided. Provision of healthcare for them would be a great achievement. Women and children are the essential component of any society and both are marginalized too.

Although the government has made some serious efforts to benefit these groups of the society like the ANM and ASHA Workers, but still a lot remains to b done to achieve our sole idea of better health coverage.

The health is not a regional or religious problem but it is a universal problem and it needs an universal solution based approach too, keeping this in mind the concept of Sustainable Development Goals (SDG) Goal no. 3 is all about the good health. Right to health will provide the health services to the differently abled people too as these are the most marginalized among the others.

UHC envisages an increased role of local self governance, institutions, panchayats in policy formulation and implementation of health care. Devolution of funds will lead to local evolution of health services.

The ‘Rangrajan Committee’ report on health clearly states that Millions of people in India come under BPL category every year because of the out of pocket expenditure on health. Right to health will help in reducing the plight of people.

There is high level of regional and inter-state disparity in health care provision in India. While the northern states like UP and Bihar suffer in health care services, southern states like Kerala and Tamil Nadu exemplary health services.

Along with the health services available the health insurance is another area where more work needs to be done, only a miniscule of Indian population has any kind of health insurance. The draft national health policy envisages the universal health insurance, so as to minimize the out of pocket expenditure. The universal preventive care will lead to lesser number of cases of diseases.

Here are some of the initiatives taken by Indian government –

  • Mission indradhanush (for immunization of children that is a step towards universal preventive care).
  • e-aushadhi portal,
  • Aayushman Bharat Scheme ;
  • Pm –matru vandana yojana and many more.

India is changing and along with Indian are changing and their lifestyle too and posing new threats to lifestyles and psychological stress and reduced fertility.

This aspect of healthcare is needed to be focused upon in right to health care.

There are some of the obstacles in achieving UHC:

  • Lack of infrastructure,
  • Lack of policy formulation and implementation at local and grass root level,
  • Lack of political will ,
  • Dearth of trained nurses and doctors,
  • Grave lack of awareness among people about their right and entitlements,
  • Lack of awareness about cleanliness, sanitisation and health,
  • Majority of Indian population is middle class ,which makes it difficult for them to take benefit of healthcare services ,
  • Faulty management and governance,
  • Environmental and climate change and many more such hurdles are present there.

All the above arguments states that universal health coverage is a right approach to reach the marginalized people of the society and provide them basic health services in general but this is not sufficient. If these thoughts are established along with some reforms are there then this effort will become fruitfull and result oriented.

I remember during 1990 central American country Costa Rica diverted all its defence spending and diverted them towards health and education.

This kind of will power and determination is needed in India to achieve the SDG goal 3.It is said in our ancient Sanskrit texts that 

    “sarve bhavantu sukhine “

    “sarve santu nirayamaya”

    “sarve bhadrani pashyantu “

    “maa kaschit dukhbhagbhavet”.

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