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LATEST NEWS UPDATES | Lancet backs WHO on need for universal health cover -Vidya Krishnan

Lancet backs WHO on need for universal health cover -Vidya Krishnan

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published Published on Sep 11, 2012   modified Modified on Sep 11, 2012
-The Wall Street Journal/ Live Mint

More than 60 million pushed below poverty line in India by healthcare costs in 2011

More than 60 million people were pushed below the poverty line in India by healthcare costs in 2011, said the Lancet medical journal, making a case for universal health coverage (UHC) in its latest issue.

This comes amid international debate on the role of insurance, affordable medicines and access to healthcare. The Lancet papers compare experiments with UHC in nine countries and agree with the assertion by World Health Organization (WHO) director general Margaret Chan that “universal health coverage is the single most powerful concept that public health has to offer”.

The papers seek to make an “ethical, political, economic and health arguments in favour of UHC”. The paper will be presented in New York on 26 September at the annual United Nations General Assembly meeting that’s attended by heads of states. In the Indian context, the paper notes that, “Prime Minister Manmohan Singh faces antagonism from groups opposed to plans for UHC in India”.

The Planning Commission will be discussing the plan on 15 September, after which it will be forwarded to the National Development Council (NDC). At the core of the debate surrounding universal health coverage in India is the implementation of user fees, role of insurance and regulation of private healthcare providers.
While the apex planning body has been in favour of user fees, health experts say there is ample international evidence suggesting this prevents access to healthcare for those who may need it most. Currently, the government’s flagship health insurance scheme Rashtriya Swasthya Bima Yojna (RSBY) requires beneficiaries to pay Rs.30 as the registration fee.

Economist Jeffrey Sachs, director of The Earth Institute at Columbia University, argues against user fees in the Lancet journal.

Even a nominal user fee “prevents access to health services by the poorest members of a poor community. Ending service fee can therefore lead to a surge in access to health services”, he said.

“The lesson is to avoid lazy thinking that small user fee will usefully require households to avoid wasteful use of health services or induce households to value health services more, or cover operational costs of local clinics,” Sachs said. “Even nominal co-payments can lead to massive exclusion of the poor from life saving health services.”

Despite RSBY and the National Rural Health Mission (NRHM) focusing on the poor, a “wide variation in coverage between socio-economic classes persists,” the Lancet report said.
“Moreover, enrolment does not necessarily mean that care is received. Studies have shown that service use within India’s RSBY scheme is far lower than expected in some regions, which raises concerns about comprehension and access to benefits.”

The Wall Street Journal/ Live Mint, 11 September, 2012, http://www.livemint.com/Politics/j2fC17mgUGAUoTwp2US15H/Lancet-backs-need-for-universal-health-cover.html


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