Healthcare Reforms
The Country’s health infrastructure of India has improved in the last two decades but it is still in
poor condition needing radical reforms to deal with emerging challenges of MDR Tuberculosis,
HIV/AIDS, and non-communicable diseases. Infant mortality rates and maternal mortality rates are
still high in some states needing corrective action. Accessibility and affordability with equity are
still a cause for concern, particularly in rural and urban slums. The Cost of healthcare needs to be
brought down considerably so that the poor and low middle-income class can afford quality care.
During the last two decades, there has been a paradigm shift in infrastructure and quality of
healthcare in the private sector in India. The role of private healthcare providers has been
continuously increasing in the healthcare sector. The out-of-pocket expenses for healthcare are
increasing day by day which needs remedial measures. The government hospitals are facing the problem
of a lack of adequate beds, resources, infrastructure, medical supplies, manpower, and finances.
In any country health care reform typically attempts to:
- Broaden the population that receives health care coverage through either public sector
insurance programs or private sector insurance companies.
- Expand the array of health care providers consumers may choose among.
- Improve the access to health care specialists.
- Improve the quality of health care.
- Give more care to citizens.
To address the problems of healthcare in rural areas and even in urban areas, the Ministry of Health
&
Family Welfare, Government of India on 12 April 2005 took a major welfare initiative by launching
National Rural Health Mission (NRHM) in 18 states with weak public health indicators and
infrastructure
and extended it across the entire country.
The mission has a special focus on 18 states Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal
Pradesh, Jharkhand, Jammu and Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland,
Orissa,
Rajasthan, Sikkim, Tripura, Uttarakhand and Uttar Pradesh.
Under the mission, health funding had increased from 27,700 crores in 2004 - 05 to 39,000 crores in
2005
- 06 (from 0.95% of GDP to 1.05%).
In 2004 the Central Government launched National Common Minimum Programme (NCMP) to ensure, through
social security, health insurance and other schemes the welfare and well-being of all workers.
However,
major healthcare reforms are needed to put the healthcare system on the right track:-
a) Central Government Health Insurance Scheme - Rashtriya Swasthya Bima Yojana
A central government-run health insurance scheme for the poor people
in India was launched on 01 April 2008. It provides cashless insurance for hospitalization
in public as well as private hospitals. It has been implemented in 25 states of India. A
total of 23 million families had been enrolled as of February 2011. The RSBY is a project
under the Ministry of Labour and Employment.
Government of Andhra Pradesh established Aarogyashri Health Care
Trust for providing health insurance to poor needy population of Andhra Pradesh
Eligibility - Scheme is open to the whole family spouse, dependent children and dependent
parents.
c) Tamil Nadu Government Health Insurance Scheme
Scheme is to provide comprehensive health care assistance to the
Employees of Government, Local Bodies, Public Sector Undertakings, Statutory Boards and
State Government Universities and their family members with provision to avail assistance up
to Rupees two lakhs. New Health Insurance scheme extended wef 11-06-2012.
d) Gujarat State Government Health Schemes
Gujarat government introduced healthcare and health insurance
schemes for 1.8 crores poor who can be treated free for critical diseases. The state will
also provide a health insurance cover of up ₹2 lakh per family to the economically weaker
sections. It will also bear part of the transportation cost of the poor.
e) The Gujarat State Government, Mukhyamantri Amrutam (MA) Yojana
Gujarat will cover surgeries for cardiovascular diseases,
neurosurgery, burns, polytrauma, cancer (Malignancies), renal and neo-natal diseases. The
state government will empanel public, private and trust hospitals for conducting surgeries.
It will cover 38 lakh families classified as Below Poverty Line (BPL).
f) Integrated Insurance Scheme in Gujarat - SEWA
Community Based Health Insurance Scheme run by NGO Self - Employed
Women Association (SEWA) is based in Ahmadabad
g) The Yeshasvini Health Insurance Scheme - Karnataka
The Yeshasvini Health Insurance Scheme was launched in 2003. It was
developed by the Narayana Hrudayalaya Foundation in association with the Department of
Cooperation, Government of Karnataka to cater 17 lakh farmers. The scheme is self-funded and
does not have insurance cover from any insurance company. Now it covers three million people
in the state, open to all income groups in rural areas provided the applicant has been a
member of any cooperative society for at least six months. It costs ₹210 a year per family
member and covers 805 surgeries in 446 network hospitals. The hospitals offer medical
consultation for free and diagnostic facilities at a discount. In cases involving
hospitalization, the trust clears the bill via a third party administrator. In 2011/12,
Yeshasvini Trust settled bills worth ₹60.27 crores against 77,738 surgeries.
h) The Karnataka State Rashtriya Swasthya Bima Yojana ( RSBY)
Initially the scheme was meant for those below poverty line (BPL),
but was alter extended State has planned to roll out 64 kb smart cards for weaker sections
of society but was later extended to domestic helpers, vendors and others. Across the
country, more than 30 lakh smart cards have been issued, and in Karnataka, approximately
17.5 lakh residents have received the cards.
i) Maharashtra Government Health Insurance Schemes
In late 2011, the Maharashtra government introduced the Rajiv Gandhi
Jeevandayee Arogya Yojana covering about 490,000 people in eight districts. In August
Maharashtra Government issued orders for the implementation of the Rajiv Gandhi Lifesaving
Health Scheme (RGLHS). The RGLHS provides health insurance to 20 million poor people in the
state of Maharashtra. AHPI endeavouring to take up with the government for providing some
form of insurance cover providing financial cover /assistance for road traffic accident
victims so that they can get treatment in hospitals.
