Why is it in the News?

As India approaches the 2024 elections, highlighting healthcare as a strategic investment rather than a fiscal burden can drive employment generation, bolster economic growth, and foster sustainable development.

Context:

• With India gearing up for the upcoming general elections, recognizing healthcare as a crucial investment for national well-being and prosperity is essential.
• Despite its pivotal role, healthcare tends to be sidelined in political discussions, necessitating a shift in focus.
• Rather than perceiving healthcare as a financial burden, it should be considered a strategic investment.
• Embracing healthcare as an investment offers substantial returns, contributing to human capital development, economic progress, and sustainable development.

What is Universal Health Care (UHC)?

• Universal Health Care (UHC) embodies the principle that everyone should have access to quality healthcare regardless of financial situation.
• It is regarded as a fundamental measure for promoting human equity, security, and dignity.
• UHC has gained widespread acceptance as a primary goal of public policy globally, with numerous countries successfully implementing it, including wealthier nations and emerging economies like Brazil, China, Sri Lanka, and Thailand.
• World Health Organization (WHO) defines universal healthcare as “all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.”

Challenges in Implementing Universal Health Care (UHC):

• Inequitable Access to Health Insurance: Disparities in health insurance coverage persist, with the lowest wealth quintile and marginalized sections facing limited access to insurance, as indicated by NFHS-5 results.
• Lack of Financial Protection: Despite initiatives like Janani Shishu Suraksha Karyakram, high out-of-pocket expenses, especially in urban areas, pose financial risks. NFHS data highlights significant disparities in expenditure across states.
• Inclusion and Exclusion Errors in Health Insurance Policies: Inaccuracies in health insurance policies, including PMJAY, lead to the inclusion of ineligible and exclusion of eligible households, affecting coverage effectiveness.
• Availability of Services: While PMJAY enlists hospitals, a significant portion is in the private for-profit sector, potentially limiting access to underserved areas.
• Inadequate Infrastructure: Insufficient healthcare facilities, equipment, and medical supplies hinder UHC implementation, compounded by a shortage of specialists in CHCs.
• Poor Health Education: Limited awareness about preventive health measures contributes to preventable illnesses, emphasizing the need for improved health education and promotion.

Steps For Achieving Universal Health Care (UHC):

• Increase in Public Health Expenditure: Commitment to allocate 2.5% of GDP to health by 2025 is crucial.
  • However, the current central budget allocation for 2024-25 falls short at 28%.
• Strategic Partnerships: The government must forge partnerships and incentivize the private sector to bridge healthcare gaps.
  • Initiatives like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) illustrate this collaborative approach, covering over 60 crore people.
• Reimbursement Rates Correction: Private sector participation is hindered by low reimbursement rates.
  • Differential pricing based on clinical excellence and infrastructure investment can encourage participation.
• Infrastructure Development: Addressing the deficit of nearly 24 lakh hospital beds requires increased private sector investment, especially in tier 2 and 3 cities.
• National Priority Status for Healthcare: Designating healthcare as a national priority sector can unlock funding opportunities and incentives, fostering growth and development.
• Strengthening Primary Healthcare: Enhancing Health and Wellness Centers and including OPD care in health insurance coverage will improve health outcomes and reduce secondary and tertiary care burdens.
• Prevention and Control of NCDs: Prioritizing interventions at the primary healthcare level can significantly reduce the burden of non-communicable diseases, preventing complications and hospitalizations.
• Boosting Private Investment: Encourage and incentivize private sector investment in healthcare infrastructure, technology, and services to expand coverage and enhance healthcare accessibility and affordability for all citizens.

How Government can Generate Employment Through UHC in India?

Expanding the Healthcare Workforce: Universal healthcare will significantly increase the demand for healthcare professionals, creating millions of new jobs. This includes doctors, nurses, paramedics, technicians, pharmacists, and other support staff. The government can address this need by:

• Scaling Up Medical Education: Increased investment in medical colleges and nursing schools is crucial.
  • This includes establishing new institutions, expanding existing ones, and introducing scholarship programs to attract talent.
  • Standards for medical education must be maintained to ensure a high-quality workforce.
• Skill Development Initiatives: Developing a robust skill development ecosystem specific to healthcare is essential.
  • This involves creating standardized training programs for various healthcare professions.
  • Skill development should not be limited to clinical skills but also encompass areas like communication, empathy, and public health awareness.
• Attracting and Retaining Talent: Competitive salaries, loan repayment programs, and career progression opportunities can incentivize students to pursue healthcare careers.
  • Additionally, considering the rural-urban divide, special incentives like higher pay and improved living conditions can attract healthcare professionals to serve in underserved areas.

Building a Robust Healthcare Infrastructure: Universal healthcare necessitates a well-developed healthcare infrastructure. This translates to significant job creation across various sectors:

• Infrastructure Development: Building new hospitals, clinics, diagnostic centers, and public health centers requires construction workers, engineers, architects, and technicians.
• Medical Equipment Manufacturing: Increased demand for medical equipment, from basic diagnostic tools to advanced technology, can incentivize local manufacturing.
  • This can create numerous jobs in production, maintenance, and research & development.
• Pharmaceutical Industry: Universal healthcare will significantly raise the demand for pharmaceuticals.
  • This can boost domestic production, generating jobs in manufacturing, distribution, and research & development.

The Role of Public-Private Partnerships (PPPs):

• The government cannot shoulder the entire responsibility alone. PPPs can play a vital role in expanding healthcare infrastructure and creating job opportunities:
• Strategic Partnerships: Collaboration with private hospitals and clinics can leverage existing infrastructure and expertise.
  • The government can purchase services from the private sector, ensuring wider reach and quality care, while creating jobs within these institutions.
• Incentivizing Expansion: Tax breaks, subsidies, and streamlined licensing processes can incentivize private players to expand their facilities and hire more staff.
  • This creates a multiplier effect, leading to job creation in construction, logistics, and other associated sectors.

Technology and its Role in Employment: Technology holds immense potential to improve healthcare delivery and create new job opportunities:

• Telehealth and Digital Health Records: Investment in telemedicine infrastructure and digital health records can create jobs in IT, data management, and cybersecurity.
  • Additionally, telemedicine can bridge the gap in rural healthcare, requiring trained personnel to operate these services.
• Medical Informatics: The use of big data and analytics in healthcare will require skilled professionals to collect, analyze, and interpret data to improve healthcare delivery and outcomes.

Conclusion

Universal healthcare in India can be a transformative force, not just for public health, but also for the nation's economic landscape. By strategically investing in workforce development, fostering public-private partnerships, and embracing technological advancements, India can unlock a vast employment potential. This not only creates a win-win for job creation and healthcare access but also paves the way for a healthier and more prosperous future for all Indians.