India’s new healthcare push can spur reforms

The last year has been truly unprecedented. Never before in history has a healthcare crisis caused an economic meltdown.

The Covid-19 pandemic has further reinforced the perils of neglecting healthcare and brought to the forefront the deep linkages between healthcare and the labour, financial, and insurance markets. It is difficult to imagine that an invisible virus could derail the economic and social well-being of citizens around the world.

Before the Covid-19 pandemic, India was already struggling to cope with the dual burden of communicable and non-communicable diseases. The pandemic has resulted in India’s fragile health system now contending with a triple disease burden. This provides us a unique opportunity to rebuild the healthcare ecosystem with a holistic approach which includes mental health and social determinants which truly underpin the health of an individual.

The government also announced the launch of the Pradhan Mantri Aatmanirbhar Swasth Bharat Yojana with an outlay of ₹64,180 crore, in addition to the budget for the National Health Mission. This scheme aims to strengthen the health infrastructure by supporting 17,788 rural and 11,024 urban health and wellness centres, setting up integrated public health labs in all districts, and establishing critical care hospital blocks in 602 districts and 12 central institutions.

The government also proposes to introduce the National Nursing and Midwifery Bill and the National Commission for Allied and Healthcare Professionals Bill. This was overdue and will give due importance to the vital role such professionals play in increasing accessibility to care.

Healthcare has been chronically underfunded and successive governments have failed to increase allocation. It is most encouraging to finally see the first steps towards the goal of spending 2.5% of the GDP on healthcare. However, a higher spend entails putting in immediate reforms to ensure the funds spent actually enhance accessibility and affordability of care. The Budget outlines a framework through which this can be achieved. Given the mammoth task at hand, bringing both the public and private sector together will be of utmost importance. The perils of both working in isolation is not something we as a country can afford given the scarcity of both physical and human resources.

Going forward, the government could look at extending the coverage of the Pradhan Mantri Jan Arogya Yojana (if required, even on a participatory/co-pay basis) to a larger section of the population and work towards increasing public-private participation and strategic purchasing of services to achieve its vision of universal health coverage—ensuring physical and financial access to a minimum level of health services for all sections of society, independent of income levels.

Investment in the primary and preventive care space will go a long way towards ensuring the physical and mental well-being of the citizens of the country. While the focus on expanding infrastructure is vital, execution will be key. Here, the government should partner with the private sector to ensure efforts are not duplicated and both the public and private sector work together seamlessly to achieve a ‘swasth India’.

Views are personal. The author, a qualified physician, is partner and healthcare leader, PwC India.