PHA-Exch> Financing health in India

[Claudio Schuftan]

>   From:    drdabade at gmail.com
>
> THE HINDU
> Date:06/04/2009
> URL: http://www.thehindu.com/2009/04/06/stories/2009040650760800.htm
> Opinion - Editorials
>
> Financing health
> The United Progressive Alliance government has lost a valuable
> opportunity to expand and improve healthcare access across the land
> and across all social sections during its five-year term. The Common
> Minimum Programme promised a public expenditure on health of between
> two and three per cent of the GDP. The actual spending (a statistic
> inflated by including spending on social determinants such as drinking
> water and nutrition) was a dismal 1.39 per cent in 2007-08. It may be
> argued that primary health care has improved in the better-performing
> States, and the National Rural Health Mission has extended services to
> far-flung populations. These measures do not, however, address the
> unaffordable cost of managing chronic ailments arising out of
> longevity or social circumstances, and of emergency medical care. An
> expanded, free, healthcare system and improved publicly funded health
> infrastructure could have benefited millions of people who did not
> seek care because of high costs, more so during an economic slowdown.
> Empirical studies show that most Indians incur impoverishing
> expenditures on health =97 because they must pay out-of-pocket. The
> National Commission on Macroeconomics and Health, using new
> methodologies, estimated in 2005 that households were obliged to use
> their own resources for 68.8 per cent of the aggregate national
> spending on health, while the share of the central and State
> governments together was 21.6 per cent (the rest was accounted for by
> public sector, private, and charitable sources).
> Government investment in health has positive externalities in the form
> of reduced social costs of morbidity and removal of inequality. Price
> subsidies or direct public provision of health facilities will
> encourage more people to seek medical care. The case for massive
> public investment in health is strong, because this vital area cannot
> be left to market forces that cater to the better-off sections. Even
> in the United States, that recognition has led to proposals from
> Democratic lawmakers for a competition-stirring, government-funded
> health insurance plan that seeks to achieve the Obama administration=92s
> goal of universal healthcare. It is imperative that India launch a
> comprehensive plan to reduce out-of-pocket expenditure for all
> citizens, build first-class primary health care, and widen access to
> tertiary care through public facilities. A special funding mechanism
> to create access to and underwrite treatment costs for chronic
> ailments, such as cardiovascular conditions, diabetes, kidney disease,
> cancer, and emergencies of all kinds must be the first step.
> Preventing millions from descending into poverty on account of
> catastrophic health expenditure must become a national priority.
> Election season is a good time to reinforce this message.
>
>
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