The Big Issue
After 14 years, Government introduced a new National Health Policy on grounds of a changed context : the rapid emergence of non-communicable diseases, increasing out of pocket and catastrophic expenditures impoverishing many, the burgeoning, profit-oriented health industry and the fiscal capacity for increased public spending due to improved economic growth.
The NHP commits itself to expanding access to every citizen with comprehensive health services by co-opting and purchasing them from the private sector in the short run while making investments in building public health infrastructure with capacity to provide the range of primary, secondary and tertiary care sectors in the long run. Targets and goals have been laid out and the commitment that public spending will be increased from the current level of 1.14% to 2.5% of GDP by 2025.
Are these amounts not too little too late? In an environment that is already facing the impact of severe market failures due to the weak interventionist role of the governments that are failing to protect patient interests, is the approach of the NHP adequate and if not what needs to be done? In further strengthening an already highly privatized health system that accounts for 80% of outpatient care and 60% of inpatient care, and where 70% of the population is still uninsured, will the health goals of improved health and reduction of catastrophic expenditures be achieved by 2025? How realistic are the claims made in the NHP.
These and many more issues will be discussed within the context of an extraordinary book, “Do We Care? India’s Health System’ written by Ms. K Sujatha Rao (Oxford University Press).
Ms Sujatha Rao was eminently suited to discuss this. In conversation with her was Dr Jayaprakash Narayan of Loksatta, who understands policy and policy making deeply.
Ms Sujatha Rao, is a former Union Secretary of the Ministry of Health and Family Welfare, Government of India. Of her 36 years’ service as a civil servant, she spent 20 years in the health sector in different capacities at the state and federal levels.
Ms. Rao was chairperson of the Portfolio Committee of the Global Fund for HIV/AIDS, TB and Malaria (GFATM) 2007-09; Member of the Global Advisory Panel of the Bill & Melinda Gates Foundation; Founding member of the Public Health Foundation of India; Member of the Advisory Board of the Ministerial Leadership Program of the Harvard School of Public Health and member of the High Level Panel on Global Risk Framework of the National Academy of Sciences, USA.
A MPA from Harvard University, USA 1991-92, she was a Takemi Fellow at the Harvard School of Public Health 2001-2002 and Gro Harlem Brundtland Senior Leadership Fellow at HSPH in 2012. She is author of the book entitled “Do We Care? India’s Health System” – published by Oxford University Press.