Niti Aayog mulls health cover for middle class families

Government thinktank Niti Aayog has suggested “consolidation” of healthcare services and providers to reduce health expenditure and improve access.

In a new report on building a 21st century health system for India, the Aayog proposed “strategic purchasing” of services, “risk-pooling”, and digitisation of health records for transformation of the healthcare sector.

The report identifies four focus areas for future systems: delivering on unfinished public health agenda, empowering citizens to become better buyers of health services, integration of services to reduce out-of-pocket spend, and digitisation of healthcare.

“Imagine a billion transactions every year where individual patients seek care from a million healthcare providers dominated by the private sector negotiating their own prices for the procedures they undergo,” the report titled ‘Health Systems for a New India: Building Blocks—Potential Pathways to Reforms’ says .

“Even among the organised players, there are multiple schemes,” the report said, highlighting multiplicity of purchasing platforms along with a highly fragmented pool of services which prevents standardisation and the best economic results.

The report was released on Monday by Aayog vice-chairman Rajiv Kumar in the presence of cofounder of Microsoft and co-chairman of Bill and Melinda Gates Foundation, Bill Gates.

The Aayog is mulling building up a healthcare system for the middle class which is still not covered under any public healthcare system.

The Aayog’s health adviser Alok Kumar said middle-class people would not worry about paying a nominal Rs.200 or Rs.300 towards building a good public health system and the plan looks feasible.

The public health expenditure in India (by the Centre and states combined) has stayed constant over the years at approximately 1.4% of GDP. On the other hand, out-of-pocket payments remain common and high, with only around 20% of the population covered by health insurance. Though Ayushman Bharat aims to expand the coverage significantly, it will take time and funding to ramp it up.

“Successful health sector transformation in India will require simultaneously reducing funding and provision fragmentation. This will facilitate the necessary leverage for effective strategic purchasing to occur, which in turn will determine the incentives for consolidating service providers and improving India’s capacity to enforce much needed patient protection, fair competition, as well as quality and efficiency regulations,” the report said.

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