India’s healthcare system is critical to achieving human and economic development goals by 2047. Despite progress, many Indians still lack access to affordable, quality healthcare. Challenges remain in availability, cost, and quality of services. The government’s Ayushman Bharat programme aims to strengthen primary care and provide financial protection. However, systemic issues require urgent attention to ensure universal health coverage (UHC) and equitable healthcare access.
Healthcare as a Pillar of Development
Health is vital for individual productivity and national prosperity. Extending both lifespan and health span ensures people live fuller, healthier lives. This supports economic growth and social well-being. A healthy population fuels India’s vision of becoming a developed nation by 2047.
Barriers to Healthcare Access
Many Indians face barriers such as lack of availability, high costs, and poor quality of care. These barriers cause foregone care or push families into poverty due to catastrophic medical expenses. Rural and small-town areas often lack adequate health infrastructure and services.
Role of Ayushman Bharat Programme
Ayushman Bharat focuses on primary healthcare through Health and Wellness Centres and hospital care via Pradhan Mantri Jan Arogya Yojana (PMJAY). It offers financial protection but faces challenges in capacity, governance, and coordination between Union and state governments.
Mixed Health System Challenges
India’s health system is a complex mix of public, private, and voluntary sectors. The private sector is diverse but often unaffordable and unevenly distributed. The voluntary sector provides charitable care but is limited in scale. Regulation and integration among sectors remain weak.
Strengthening Public and Private Sectors
Public sector capacity and efficiency must improve. The private sector should adopt responsible pricing and avoid unnecessary procedures. Voluntary organisations need to build community-linked care models. Partnerships among all sectors should aim for public health goals, with the public sector ensuring standards and accountability.
Expanding Primary Healthcare Infrastructure
Healthcare must be accessible close to home in both rural and urban areas. This requires better infrastructure, road connectivity, emergency transport, and digital health services like telemedicine. Primary care can be enhanced by training non-physician providers to reduce burdens on higher-level facilities.
Health Workforce and Pluralistic Medicine
A multi-skilled health workforce is essential, with fair distribution across regions. Both allopathic and traditional medical systems should be supported with clear roles and resources. This pluralistic approach can broaden healthcare reach and cultural acceptance.
Funding and Financial Protection
Government health spending must increase to at least 3% of GDP. Out-of-pocket expenses should be reduced below 20% of total health expenditure. Expanding insurance coverage under PMJAY and providing free essential medicines, diagnostics, and vaccines in public facilities are key priorities.
Equity in Healthcare Delivery
Equity must guide healthcare design. Horizontal equity ensures everyone receives basic services. Vertical equity allocates more resources to disadvantaged groups who face historic health inequities. Pooled procurement of medicines and diagnostics can lower costs for all.
Integration and System Coherence
Disconnects between primary care and hospital insurance schemes must be resolved for integrated care. Coordination between public and private sectors and between allopathic and traditional systems is vital. A unified, empathetic, and economically sustainable system is needed for universal health coverage.
Questions for UPSC:
- Discuss in the light of India’s federal structure how cooperative federalism can enhance the delivery of universal health coverage in the country.
- Critically examine the challenges and opportunities of integrating traditional medicine systems with allopathic healthcare in India’s pluralistic health system.
- Explain the role of digital health technologies in strengthening primary healthcare services and reducing urban-rural disparities in access.
- With suitable examples, discuss how public-private partnerships can be leveraged to improve healthcare infrastructure and affordability in developing countries.
