Healthcare Gap in India Highlighted

Healthcare Vulnerability: Over 40 crore Indians are reportedly caught in a healthcare gap, constituting more than a quarter of the population. This group is too wealthy to rely on government subsidies yet not financially secure enough to afford rising private healthcare costs.

Parliamentary Report: A report by the Parliamentary Standing Committee on Health and Family Welfare, titled ‘Affordability and Accessibility of Healthcare Facilities in Public and Private Sector,’ outlines this healthcare gap and makes 368 recommendations aimed at improving affordability and accessibility.

Healthcare Delivery: More than 60% of inpatient care and 70% of outpatient care in India are delivered by the private sector, leaving many households without adequate financial protection from high private costs.

Health Expenditure: Medicines account for nearly 30% of current health expenditure, creating a substantial financial burden for individuals, particularly those with chronic conditions like diabetes, hypertension, and cardiovascular disease.

Public Spending on Health: The report highlights a structural issue in the healthcare system, noting that government health expenditure stands at 1.43% of GDP, lower than the 2.5% target specified in the National Health Policy, 2017. Additionally, health spending as a share of total government expenditure decreased from 6.12% in 2021-22 to 4.89% in 2022-23.

Out-of-Pocket Expenses: The average out-of-pocket expenditure on childbirth in private facilities is approximately ₹37,630, compared to ₹2,299 in public facilities, indicating a significant disparity in costs.

Government Schemes: The Ayushman Bharat - PM-JAY scheme provides hospitalization coverage for vulnerable households. However, those in the 'missing middle' often do not qualify for these fully subsidized services, leaving them vulnerable to high healthcare costs.

Insurance Challenges: The report asserts that private insurance may not adequately protect households due to issues like high premiums, exclusions, waiting periods, and co-payments. Thus, merely providing insurance is not a solution to the healthcare gap.

Recommendations for Improvement: The Committee calls for:

• Strengthened public healthcare infrastructure.
• Nationwide implementation of the Clinical Establishments Act.
• Mandatory quality standards and greater price transparency in private healthcare facilities.
• Stricter regulations on pharmacy practices, including excessive trade margins and the non-prescription sale of antibiotics.

Conclusion: The report emphasizes the need for more than just insurance coverage to address healthcare gaps. There's a crucial need to protect the millions who fall between the wealthy and the impoverished, as their financial vulnerabilities accumulate from the ongoing costs of maintaining health, rather than from single medical emergencies.