Most middle-class taxpayers in private jobs are stuck between the devil and the deep sea when it comes to accessing quality, and yet affordable, healthcare. Their faith in government hospitals is eroding, and dependence on expensive private hospitals is increasing.
While the government claims to cover 50 crore poor people under the cashless health insurance scheme Ayushman Bharat, officials say a much lesser population is being tracked in urban areas because of lack of proper addresses in the Socio-Economic Caste Census. The rest of the population, except government employees, are bereft of any government sponsored health cover or subsidy.
In 1948, the World Health Organisation had enshrined ‘Universal Health Coverage’ — which means quality health services provided at affordable costs — as a fundamental right of each citizen. Seventy-two years have passed without that becoming a reality in India, even as the country acceded to this in 1979 and hence making it obligatory to progress towards the goal.
To expand the health net, the government will also have to increase its healthcare budget, which is currently around 1.5 per cent of GDP. As per the government’s own reckoning, the budget has to be scaled up by 26 per cent year-on-year to achieve a target of 2.5 per cent of GDP by 2025. And even as the government aims at ushering in universal health coverage, it has not charted a way forward yet — for example, whether pooling of premium is mandatory or voluntary for the taxpayer to have accessi to healthcare.
But the biggest hurdle to universalising access to health is improving and regulating the quality of care. In the event of non-upgradation, taxpayers may have to pay up but not get care in their choice of hospital. This apart, doctors themselves are the biggest roadblock, as they oppose implementation of The Clinical Establishments Act, which aims at regulating the quality of care. While funds for schemes can gradually be figured out, improving and regulating the quality of care is a bigger issue. Without addressing this, talking about access to healthcare is futile.