Universal Health Care in India: A Critique of the Insurance-Based Model
UPSC Relevance
Prelims: Social Development, Health, Social Sector Initiatives (Ayushman Bharat - PM-JAY); Government Policies; Key Committees (Bhore Committee).
Mains:
General Studies Paper 2: Issues relating to development and management of Social Sector/Services relating to Health; Welfare schemes for vulnerable sections of the population and the performance of these schemes; Government policies and interventions.
Essay: Topics on Health, Governance, and Inclusive Growth.
Key Highlights from the News
The article strongly argues that an insurance-based model like Pradhan Mantri Jan Arogya Yojana (PM-JAY) alone will not be sufficient to achieve the goal of Universal Health Care (UHC).
While these insurance schemes provide temporary relief to poor patients, they have several structural shortcomings.
Main shortcomings:
It promotes for-profit medicine in private hospitals.
It focuses only on expensive hospitalisation instead of concentrating on primary care and outpatient treatment.
Despite being enrolled in the scheme, many are unable to utilize it (utilisation problems). It fails to reduce out-of-pocket expenses.
It leads to discrimination in hospitals between those with and without insurance.
There is a high potential for corruption and abuse.
The real problem in India's health sector is the very low government investment in public health facilities (under-investment in public health).
India's public health expenditure is only 1.3% of GDP, which is much lower than the global average of 6.1%.
Without fundamentally strengthening the public health system, India cannot achieve UHC solely through insurance schemes.
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