Model Answer
0 min readIntroduction
The Indian healthcare system is undergoing a significant transformation, with increasing private sector participation and a growing marketization of services. While this can lead to innovation and greater choice, it also poses risks to equitable access, affordability, and quality, particularly for vulnerable populations. The core principle of ‘health for all’ enshrined in Article 21 of the Constitution necessitates a strong role for the state in ensuring universal healthcare access. Recent trends like the rise of corporate hospitals and medical tourism highlight the need for proactive state intervention to contain the adverse impacts of marketisation and enhance the reach of public healthcare at the grassroots level.
Strengthening Public Healthcare at the Grassroots
The Indian State can enhance the reach of public healthcare through a multi-pronged approach focusing on infrastructure, human resources, financing, and governance.
1. Infrastructure Development & Accessibility
- Strengthening Primary Healthcare Centres (PHCs): Invest in upgrading PHCs to Health and Wellness Centres (HWCs) under the Ayushman Bharat scheme, providing comprehensive primary care services including preventive and promotive healthcare, maternal and child health services, and management of common non-communicable diseases.
- Improving Rural Connectivity: Ensure adequate transportation infrastructure (roads, ambulances) to facilitate access to healthcare facilities, especially in remote and underserved areas. Utilizing technology like drone delivery for essential medicines and supplies can be explored.
- Telemedicine Expansion: Scale up telemedicine services, particularly in areas with limited specialist availability. The eSanjeevani platform, a digital health initiative, can be leveraged for remote consultations and diagnostics.
2. Human Resource Augmentation
- Increasing Healthcare Workforce: Address the shortage of doctors, nurses, and other healthcare professionals, particularly in rural areas. Incentives like higher pay, better working conditions, and opportunities for professional development can attract and retain healthcare workers.
- Investing in Skill Development: Enhance the skills of existing healthcare workers through regular training programs and continuing medical education. Focus on public health skills, community health nursing, and management of common diseases.
- Leveraging ASHA Workers: Strengthen the role of Accredited Social Health Activists (ASHAs) as frontline health workers, providing them with adequate training, support, and remuneration.
3. Financial Mechanisms & Resource Allocation
- Increasing Public Health Expenditure: Increase the allocation of public funds to healthcare, aiming to reach at least 2.5% of GDP as recommended by the National Health Policy 2017.
- Strengthening Health Insurance Schemes: Expand the coverage and benefits of health insurance schemes like Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY), ensuring access to quality healthcare services without financial hardship.
- Decentralized Funding: Empower local bodies (Panchayats and Municipalities) to manage and allocate funds for healthcare services, ensuring responsiveness to local needs.
4. Governance & Regulation
- Strengthening Regulatory Framework: Strengthen the regulatory framework for the private healthcare sector, ensuring quality standards, fair pricing, and ethical practices. The Clinical Establishments (Registration and Regulation) Act, 2010 (yet to be fully implemented) needs to be operationalized.
- Promoting Public-Private Partnerships (PPPs): Explore PPPs in specific areas like diagnostics, medical equipment, and hospital management, ensuring that public interest is prioritized and access is not compromised.
- Improving Data Management: Establish a robust health information system to collect, analyze, and disseminate data on health indicators, disease prevalence, and healthcare service utilization. This will facilitate evidence-based decision-making and resource allocation.
Furthermore, addressing social determinants of health – such as poverty, sanitation, and education – is crucial for improving health outcomes at the grassroots level. Inter-sectoral coordination between health, education, water and sanitation, and social welfare departments is essential.
Conclusion
Containing the adverse impacts of marketisation in public healthcare requires a proactive and sustained role for the Indian State. By strengthening infrastructure, augmenting human resources, ensuring adequate financing, and improving governance, the state can enhance the reach of public healthcare at the grassroots level and move closer to achieving universal health coverage. A balanced approach that leverages the strengths of both the public and private sectors, while prioritizing equity and affordability, is crucial for building a resilient and responsive healthcare system for all citizens.
Answer Length
This is a comprehensive model answer for learning purposes and may exceed the word limit. In the exam, always adhere to the prescribed word count.