india

Updated: Nov 18, 2019 03:13 IST

NITI Aayog has proposed structural reforms in the health sector with focus on four key areas -- health system risk pool financing, health services, organisation, and digital health care -- in its report “Health System for a New India: Building Blocks - Potential Pathways to Reform”, according to government documents and people familiar with the matter.

The report is scheduled to be released on Monday by NITI Aayog vice-chairman Rajiv Kumar and Bill Gates, co-chairman of the Bill and Melinda Gates Foundation. The government think-tank has drafted a 15-year plan with the aim of transforming the health sector.

“A three-year action agenda and a seven-year strategy have already been prepared by NITI Aayog. We are now engaging in developing a 15-year vision document for the nation’s development... This book is an attempt to bring together all the valuable findings of the studies, including supporting data from this analysis. With regards to financing, the book talks of improving financial risk protection and reforming fiscal transfers. For better provisioning of health care services, strengthening primary care, accelerating human resource development, implementing digital information systems, and improving access to quality medicines are some of the suggested areas of focus,” Niti Aayog CEO Amitabh Kant wrote in the report, whose foreword was accessed by HT.

In June, NITI Aayog also released its health index rankings that mapped the state of health care across states. Kerala emerged at the top of the second edition of NITI Aayog’s “Healthy States, Progressive India” report. Uttar Pradesh was rated as the worst as per the parameters.

In its latest report, the think-tank has proposed a “complete transformation” of India’s health system.

“There remains a need to strengthen the broad ecosystem in which health services are delivered. For this, we need to chart a clear road map to the complete transformation of India’s health system...Our vision for a healthy India requires us to holistically transform the delivery of health services in both public and the private sectors, across levels of care,” said Dr Vinod Paul, member, NITI Aayog.

“At a system level, overcoming the challenges of fragmentation, across health care financing and service delivery, will help us optimise both quality and access. For a large country like ours, efforts aimed at aggregation and standardization will contribute to enhancing both efficiency and quality. Achieving this will require us to make major institutional changes,” he added.

The think-tank has also suggested that India’s public and private financing system of health care needs to be regularised and become more economical.

“Instead of looking at schemes in the health sector, we are not focusing on sectoral reforms. With the help of international consultants and local experts we have key areas of focus. The system of public and private health care financing such as the Army’s ECHS scheme etc. needs to be looked at. The system is fragmented and we need to see how to bring in regularisation. We have to find a way to make purchasing more economical,” said a senior NITI Aayog official who asked not to be named.

Dr K Srinath Reddy, president, Public Health Foundation of India, said, “Health care financing should be consolidated. The private sector too should be brought in to contribute in the scheme for universal health care. However, while building a single-payer system, we must also strengthen public health care otherwise the private sector will emerge dominant.”

A single-payer health care system is a type of universal health care financed by taxes that covers the costs of essential health care for all residents, with costs covered by a single public system.