The theme “National Health Policy 2017: Decisive steps towards Health Assurance”, is a statement of Vision and Mission which will lead the country to achieve Sustainable Development Goals by 2030. It sets out 3 clear Goals viz. Progressively achieve Universal Health Coverage, Reinforce Public Health Systems, Alignment of Private and Public Health Goals. The salient feature is the clear articulation of “Assured” Health Services which will facilitate realization of Universal Health Coverage. It also thinks beyond Government facilities to include private sector meaningfully through strategic purchase of health services and private investments. However, the policy also reflects a pragmatic approach as it evades “Right to Health” approach and instead promotes “Health Assurance”. The time-line for achieving the relevant policy indicators are ambitiously set much before the year 2030 – the target for achievement of the Sustainable Development Goals(SDGs).
The contribution of GDP to Health is being raised to 2.5% in a phased manner in the next 5 years but the provision is still inadequate compared to the other developing countries. International experts state that minimum 5% of GDP or 85 USD($) per head are necessary to achieve SDGs. Our current spending is 17 to 20 dollars per head.
There has been a reduction in the central budgetary provision to key National Health Programs such as National Health Mission, ICDS etc. The onus is shifted to the respective states to generate revenue for the Health Programs. This may indirectly lead to adoption of “User Fees” or “Recovery of Cost” approach in public health sector, adversely influencing health Equity and Social Inclusiveness.The rising cost of treatment and hospitalization are major concerns as the policy is silent on regulation of medical costs in private sector. The enforcement of Clinical Establishment Act and regulation of National Pharmaceutical Pricing Authority also deserve due attention. The private sector accounts for 70-80% health care.The people rely on private health care providers and therefore inevitably bear the brunt of Out of Pocket Expenditure. This invariably may push a large segment of population below poverty line. Evidence shows that public and private sector cannot co-exist in the same space, given the competitive environment. In such a frame-work, the “risk” is largely borne by Government sector with little liability on the private sector. The strong “Interventionalist” role of the government may be compromised.
Better Health Outcomes will result in better Demographic Dividends but if implementation of the policy is unrealistic, it may create an “Economic Divide”. The consolidated, integrated contribution of expertise from Health Technocrats, Private Practitioners, Health Industry, Academicians, Social Scientists, Researchers, NGOs, Politicians and Administrators becomes relevant and meaningful to overcome the Challenges in realization of the National Health Policy Goals.
The Conference theme therefore provokes a debate for all delegates to participate through its proceedings and evolve practical need-based solutions and also provide feedback to policy makers for successful implementation National Health Policy 2017.