New Delhi: For the first time since Independence, the Indian government has moved towards making health a constitutional guarantee, the denial of which will be punishable.

The health ministry on Wednesday released a draft of the National Health Policy 2015, a document that will provide an overarching framework for the government’s health targets.

The document answers one of the fundamental policy questions of our times—whether to pass a health rights Bill making health a fundamental right in the way that was done for education.

“The Centre shall enact, after due discussion and on the request of three or more states a National Health Rights Act, which will ensure health as a fundamental right, whose denial will be justiciable," the document states.

States would be able to voluntarily opt for this by a resolution of their legislative Assembly. According to the policy, states with a per capita public health expenditure rate of over ₹ 3,800 (at current prices) should be in a position to deliver on this.

“Such a policy formulation/resolution we feel would be the right signal to give a push for more public health expenditure as well as for the recognition of health as a basic human right, and its realization as goal that the nation must set itself," the document says.

The draft policy has been placed in the public domain until 28 February 2015 for stakeholders’ feedback. The Narendra Modi government is also keen to explore the creation of a health cess on the lines of the education cess for raising the money needed to fund the expenditure it would entail.

While the overall intent seems to be moving towards ‘universalization’ of health coverage, the document relies heavily on private sector.

While the public sector is to focus on preventive and secondary care services, the document recommends ‘contracting out’ (read purchasing) services like ambulatory care, imaging and diagnostics, tertiary care down to non-medical services such as catering and laundry to the private sector.

The private sector today provides nearly 80% of outpatient care and about 60% of inpatient care.

Another significant proposed policy change is that the government actively wants to work towards a “change in mindset" where people move away from “imagining public hospitals as social enterprises that ideally must recover the costs of their functioning, to reimagining them as part of a tax-financed single-payer healthcare system in which, what public hospitals deliver is not free care, but rather pre-paid care."

The other corollary of viewing public services not as free, but as pre-paid services is that quality of care would become an imperative.

The policy statement also assures universal access to free drugs and diagnostics in government-run hospitals. Since independence, India has twice drafted a National Health Policy framework—once in 1983 and then in 2002—which have guided the approach towards the health sector in Five-Year plans.

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