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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-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.

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.

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.

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).

Community Based Health Insurance Scheme run by NGO Self – Employed Women Association (SEWA) is based in Ahmadabad

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.

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.

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.

Infrastructure Issues

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.

India is one of many countries facing a severe shortage of trained medical professionals—including nurses, dentists, and administrators—but especially doctors. By the most recent data, the United States has 2.672 doctors per 1,000 people and 3.1 hospital beds per 1,000 people. India, on the other hand, has a mere 0.599 doctors and 0.9 hospital beds per 1,000 people.

Going by these numbers, India would need almost 2.4 million new doctors and over 2 million more hospital beds to reach the same proportions as the United States. The World Health Statistics says that India ranks among the lowest in this regard globally, with 0.9 beds per 1,000 population – far below the global average of 2.9 beds. India’s National Health Profile 2010 says India has a current public sector availability of one bed per 2012 persons available in 12,760 government hospitals – around 0.5 beds per 1,000 populations.

AHPI proposes to address these issues for the benefit of community with Central Government and State Government, by proposing to off load many healthcare management and logistic tasks to private sector.

Environmental Protection

Environmental degradation is the deterioration of the environment through the depletion of resources such as air, water, and soil; the destruction of ecosystems and the extinction of wildlife. It is defined as any change or disturbance to the environment perceived to be deleterious or undesirable. Environmental pollution and ecological degradation have resulted in economic losses. There are many environmental issues in India. Air pollution, water pollution, garbage, and pollution of the natural environment are all challenges for India. Major environmental issues are forest and agricultural degradation of land, resource depletion of water, minerals, forest, sand, rocks, etc. environmental degradation, public health, loss of biodiversity, loss of resilience in ecosystems, livelihood security for the poor. A few of the concerns for environmental issues are listed below, which need attention at all levels and in all industries including the healthcare industry.

AHPI proposes to address these issues for the benefit of the community with the Central Government and State Governments, by proposing to offload many healthcare management and logistics tasks to the private sector.

List of environmental pollution and degradation issues needing attention:-
  • Global warming, CFC, ozone depletion, greenhouse gases.
  • Depletion of fossil fuels, deforestation.
  • Rise in sea level.
  • The environmental impact of the coal industry, habitat destruction.
  • Lead poisoning, hydraulic fracturing’s environmental impact, overgrazing, pesticides.
  • Land pollution, soil conservation, genetically modified food controversies, nanotoxicology, nuclear and radiation accidents, noise pollution.
  • Oil spills, marine pollution, acid rain, volatile organic compounds, blast fishing, toxic waste, electronic waste, and so on.

AHPI proposes to create a data bank and be a repository of all relevant acts, rules and remedial actions on environmental pollution including pollution caused by hospitals and other healthcare organisations. AHPI will provide assistance to desirous hospitals and other healthcare provider members necessary assistance for disposal of biomedical waste and best methodology and technology, i.e. incinerators.