As India seeks to become a global power, there is perhaps nothing more important than the health and well-being of its citizens. This is ensured in part through an effective, comprehensive health system. However, despite large tertiary care hospitals in both public and private sector driving in change through latest technologies, a majority of these services still remains beyond the reach of the common man.
Various announcements made by Prime Minister Narendra Modi over the past year have hugely galvanized the national sentiment into hope for more comprehensive reform in the Indian healthcare system. The national movement for ‘Swachh Bharat’, can also be viewed as ‘Swastha Bharat’, as it comprises of a series of public health initiatives towards implementing preventive and promotive health. Extending and improving the availability of clean drinking water, the coverage of sanitation facilities, drainage and regular garbage disposal, besides appropriate solid waste management, are some of the steps that will immediately sustain a cleaner environment.
….the government’s overarching goal of healthcare is to provide, with the help of state governments, ‘Health Assurance to all Indians and to reduce the out-of-pocket spending on health care’. This vision is achievable thanks to building blocks created in the last 3-4 years by the Health Ministry
FICCI believes, that the time is ripe to bring in a paradigm shift in the health system of India, leading to certain fundamental structural and systemic changes that are imperative to achieve the national goal of universal health coverage (UHC). We need to recognize that the three tier healthcare delivery system i.e. the primary, secondary and tertiary levels have not fully served the purpose they were intended for. In fact prevention should become a critical and separate sub-system of health care with a ‘fourth layer, the pre-primary layer’, below the primary care. This would help in creating a comprehensive assured continuum of care.
Although India has made significant progress in the last six decades on various health parameters, our neighbours China, Sri Lanka and countries like Thailand, Philippines rank much higher. Most of the emerging economies are increasingly buying the argument that health care has to have a strong public provision component either in delivery or financing or both. All large developing economies have either taken steps or are actively considering moving toward UHC.
We understand that the Indian government, in its endeavour to make healthcare accessible and affordable, is increasingly seen to be moving from being a provider to a payor especially with the expansion of Government Sponsored Health Insurance Schemes (GSHIS) with estimates of covering 500 million people by 2015. However, the fact that public spend on healthcare has remained static at ~1.2% against the desired 2.5% and was further decreased in the budget announced for 2015-16 is certainly discouraging.
The government’s overarching goal of healthcare is to provide, with the help of state governments, ‘Health Assurance to all Indians and to reduce the out-of-pocket spending on health care’. This vision is achievable thanks to building blocks created in the last 3-4 years by the Health Ministry, as highlighted below:
- Development of Standard Treatment Guidelines for ~230 conditions across 20 disease specialties for secondary and tertiary care will help in standardisation of treatment and procedures; ensure more predictable outcomes and contain costs, to the extent possible, by reducing unnecessary investigations. The Health Ministry has yet again initiated the process of expanding the list to include primary care and updating previous guidelines under the National Health Mission. The guidelines are being further streamlined with ‘Decision Trees’ to guide the healthcare worker / doctors at the Primary Health Centre (PHC) level.
- Electronic Health Records (EHR) is the single most standard tool to help in data warehousing, monitoring and portability which would greatly reduce diagnostic time and help in creating a national health database. This should pave the way for an all-encompassing health information portal, which has detailed demographic data helping in periodic review of disease-wise, city-wise and region-wise information. The Health Ministry has already initiated the setting up of the National eHealth Authority (NeHA) to ensure that the regulatory mechanism in place. For implementation of EHR, the Ministry has established the Indian Health Information Network (IHIN). This think tank would be a platform for sharing eHealth solutions, learning from eHealth experiences, discussions on policy level issues and would function as a champion for eHealth practices and standards.
- National Costing Guidelines is an effort to establish and authenticate the cost of various healthcare services in the country, including key treatments and diagnostic tests in a scientific manner to rationalise the cost of care. The guidelines have looked at creating a standard costing templates, harmonizing coding and procedures and studying reimbursement procedures under various State Governments.
FICCI has taken a lead from the private sector and is actively engaged in coordination and facilitation for all the above mentioned initiatives on behalf of the Ministry of Health and Family Welfare, Government of India.
Simultaneously, the Insurance Regulatory and Development Authority (IRDA) has been working closely with FICCI to standardize several operational areas like billing & discharge formats, critical illness definitions and development of insurance products for chronic care, care of the elderly, primary care to quote a few. These would not only streamline the operational issues but will also provide more health insurance products for consumers to choose from.
The industry endorses government’s initiatives and believes that this is an opportune time to evolve our PPP strategies and adopt a collaborative approach between the public and the private sector to collectively face the challenges and build on each other’s strengths.
PM Modi’s recent public schemes for Insurance and Pension are aimed at reducing the burden of the common man. In a similar manner, FICCI proposes to create a virtual pool of CSR funds specifically for health proposed to be named ‘IISH (Indian Industry in Solidarity for Health) Kosh’.
…We also urge the PM to make an announcement on ‘Swastha Bharat’, similar to ‘Swachh Bharat Abhiyan’, to make healthcare as the national priority for this year. This could help to generate a corpus of over INR 1000 crore that could be utilised for achieving national health priorities. It would also facilitate achieving the Universal Health Coverage objectives in next 10 years and transform the Indian healthcare system.” – Dr Nandakumar Jairam, Chairman, FICCI Health Services Committee and Chairman & Group Medical Director, Columbia Asia Hospitals India
Further, FICCI would be providing an exclusive platform through its annual healthcare conference, FICCI HEAL 2015, ‘Indian Healthcare: Time for Paradigm Shift’, on Aug 31-Sept 1, 2015 at FICCI, New Delhi. The conference would be a conglomeration of policy makers and leaders from healthcare and associated industries to deliberate on various approaches, opportunities and best practices that can help India achieve these reforms and leapfrog to health and wellbeing.