The Indian healthcare system

Prior to this year, healthcare spending made up only 1% of the Indian budget. Based on 2018 expenditure figures (adjusted for differences in costs of living), India ranked 140th for healthcare spending of countries per capita.

So what healthcare services are Indian citizens entitled to (if any)? Do we have universal healthcare?

The purpose of universal healthcare is to:

• Make a broad range of essential health services accessible to everyone

• Ensure everyone can receive these services without incurring expenditure which is more than 10% of the monthly household expenditure

The first criteria is far from being fulfilled. A study conducted in 2018 showed that “about 55 million Indians were pushed into poverty in a single year because of having to fund their own healthcare and 38 million of them fell below the poverty line due to spending on medicines alone”.

As for the second criteria, prior to 2018, the Rashtriya Swasthya Bima Yojana (RSBY) was in place which covered the costs of hospitalisation for specific conditions, up to a maximum of Rs 30,000 for five members of each household living below the poverty line. These services could be availed from public hospitals and private hospitals that chose to participate in the scheme. However, it did not cover outpatient care or the cost of medicines.

The scheme didn’t prove to be that effective.

“According to the RSBY website, around 37.7 million BPL families were enrolled in the RSBY scheme nationwide in 2018, representing only 15% of the estimated 250 million BPL households.”

“There were wide variations in population coverage, with district-level coverage ranging from as high as 90% in some districts of Punjab to around 22% in Maharashtra.”

Seeking to extend coverage to non-BPL families, to increase the financial coverage and to make the scheme portable across states, the government (in 2018) announced a scheme that aims to provide 100 million poor and vulnerable households (approximately 500 million people) with a package of Rs 500,000 per household per year.

But healthcare services provided without admission to hospitals or certain institutes are still not covered (which makes it difficult for inaccessible communities to utilise the scheme) and neither is the high cost of medicines.

Studies in 2018-2019 showed that there are still significant inequalities in terms of accessing and utilising the scheme. For example, “states with the highest needs — in terms of the proportion of people living below the poverty line and disease burden — had enrolled fewer beneficiaries and had much lower utilisation rates than the better-off states.”

So what do you think is the road ahead? Let us know in the comments!

Bibliography:

https://economictimes.indiatimes.com/news/politics-and-nation/health-spending-pushed-55-million-into-poverty-in-a-year-study/articleshow/64568199.cms?from=mdr

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3483505/

https://www.theindiaforum.in/article/towards-universal-health-coverage

https://life.futuregenerali.in/life-insurance-made-simple/cancer-heart-critical-illness-insurance/does-india-have-universal-health-insurance-coverage

https://news.harvard.edu/gazette/story/2021/02/whats-the-future-for-healthcare-in-india/

https://www.theindiaforum.in/article/towards-universal-health-coverage