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Resource centre on India's rural distress
 
 

Draft ducks hospital bills
-The Telegraph

New Delhi: The Narendra Modi government may introduce a health cess to fund free health care services and launch seven preventive campaigns to curb illnesses under a draft health policy unveiled today.

Some analysts, however, said the draft of the National Health Policy 2015 lacked emphasis on regulating India's private health industry, necessary to curb the high cost of health care.

The draft says the government has the "political will" to ensure universal access to affordable and assured health care and will explore the option of a health cess on the lines of the education cess to raise the money.

Released by the Union health ministry, the policy comes amid longstanding concerns that persisting gaps in health care financing and services are pushing an estimated 60 million Indians into poverty every year despite the country's economic growth.

Earlier this year, the health ministry had said it had initiated steps to define and deliver a package of free medicines and diagnostic services in addition to health care consultations through government hospitals and clinics across the country.

According to the new policy, the government will rely on general taxation as the major source of health care financing.

The proposed health cess will also mobilise contributions from special commodity taxes, including taxes on tobacco and alcohol. The policy also proposes to raise additional health funds through special taxes on "extractive industries and development projects that result in displacement or those that have negative impacts on natural habitats".

A public health specialist who asked not to be named said that while the policy document's contents were encouraging, its success would depend on the details of the health care initiatives and on whether the promised funds were made available.

Senior health officials had indicated earlier this month that the government was likely to cut the current health budget by 20 per cent.

"If such trends continue, we'll have a nice-looking document but no real difference on the ground," the specialist said.

The government also wants to launch preventive health campaigns focused on cleanliness and sanitation, healthy diets, tobacco and alcohol, road traffic, stress, air pollution and gender violence to curb illness, injuries and violence against women, including prenatal sex determination.

The seven campaigns, which the government has said could be collectively called the Swasthya Nagrik Abhiyan (social movement for health), will focus on communities, households and individuals and seek to build a "social environment" to induce behaviour change, the draft says.

Acknowledging that the existing primary health care is fragmented from secondary and tertiary-level care, the government has also pledged to bolster infrastructure, referral mechanisms and human resources to ensure that patients who approach primary centres are assured continuity in care.

Health policy analysts have welcomed the government's proposals to generate tax funds for health care and improve public health care facilities, but cautioned the policy does not clearly address the issue of regulating India's private health care sector.

"This is a compromise document," said Abhay Shukla, a public health physician and coordinator of the non-government health organisation Saathi-Cehat.

"It is good that the government wants to raise taxes for health care, but the policy is silent on the need to regulate the rates of health care services."

Sections of health policy analysts have been worried that payments for health care services --- whether consultations or surgeries or diagnostic tests --- remain virtually unregulated in the country, exposing patients to high costs of health care and even irrational health care.

The government, in its policy document, has acknowledged the growing concerns about costs and unethical practices like kickbacks and supply-driven irrational care as well as denial of services.

"Much greater emphasis must therefore go into making (the) regulation work," the document said.

But analysts say this is not enough. "There are no concrete proposals for regulating prices," Shukla said.