Health Ministry seeks Rs. 50,000 crore allocation
- The Union Health and Family Welfare Ministry has pitched for an increase in its budgetary allocation, citing plans to strengthen the delivery of existing schemes and roll out ambitious programmes such as the universal health assurance mission to provide a certain quantum of drugs and diagnostics free.
- The Ministry has sought Rs. 50,000 crore as budgetary allocation, saying its record of spending funds has improved over the years and there is demand for expanding the bouquet of its services. Though the government is being pressured to increase the allocation from just over one per cent of the GDP, a big jump is unlikely.
- The 12th Five Year Plan proposed Rs. 1.9 lakh crore for the health sector, but in the first three years, the sector received only Rs. 55,000 crore. Ministry officials said they needed at least a 10-15 per cent increase from last year’s Budget estimate of Rs. 30,000 crore to strengthen schemes such as the National Rural Health Mission, the Janani-Shishu Suraksha Karyakram and the Rashtriya Bal Swasthya Karyakram, strengthen district hospitals and distribute drugs and diagnostics free.
- Ruling out a separate fund for the Universal Health Assurance Mission, the official said the Ministry was looking at rolling it out in phases and the allocation sought is sufficient to cover some components of the scheme.
Universal Health Assurance Mission
- The proposed UHAM will make 348 essential drugs besides Ayurveda, Unani, Siddha, and Homoeopathy (AYUSH) drugs available free of cost to everyone. It will provide free diagnostics at primary, sub-centre and district levels while continuing with existing schemes such as Janani Suraksha Yojana. It will expand Rashtriya Swasthya Bima Yojana (RSBY), the existing insurance scheme for BPL families, from Rs. 30,000 to Rs. 50,000 and include select tertiary care. "Population other than poor would be included on the basis of prepayment of part or full premium based on income-levels, or on basis of co-payment of a share of an approved sharing package," says the draft outline. A National Health Assurance Agency and similar agencies at the state level will be set up to decide on purchase of care and costing, among other features.
- The focus is to shift from care during sickness to wellness care, or preventative care, by making screening facilities more accessible. In some cases, service providers may be allowed to provide facilities at government campuses. The RSBY insurance coverage will be subsumed and expanded under UHAM.
- At present, under RSBY 17 private insurers provide insurance cover to 3.75 crore BPL households in 24 states. Tamil Nadu, Maharashtra and Andhra Pradesh offer secondary and tertiary care to beneficiaries using models other than RSBY. Even Kerala with its robust public health system is not able to provide all services to its entire population. Governments will find it difficult to reimburse private hospitals directly, and need intermediaries such as private insurers, or a Trust. The draft needs to define clearly and monitor the pathways for treatment of different conditions so that there is no over-prescription or unnecessary hospitalisation.
- UHAM is expected to have a budget of Rs. 1,20, 932 crores over five years, to be shared 75: 25 between the Centre and the States, in addition to the existing health budget. It is scheduled to be launched in 72 districts in the next financial year, and extended to 268, 469, and later, all 670 districts.
- There should be expanded role for the public sector in primary and secondary health care. Private care providers would play a limited role, in tertiary care - which is institutional care for acute conditions and surgeries.
- At present, 60 to 70 percent of all primary and secondary care is given through the private providers. It is not clear how this will move to public health systems. However, many have questioned the capacity of the public sector to deliver expanded secondary care.
Rashtriya Swastha Bima Yojana
- RSBY has been launched by Ministry of Labour and Employment, Government of India to provide health insurance coverage for Below Poverty Line (BPL) families.
- The objective of RSBY is to provide protection to BPL households from financial liabilities arising out of health shocks that involve hospitalization. Beneficiaries under RSBY are entitled to hospitalization coverage up to Rs. 30,000/- for most of the diseases that require hospitalization. Government has even fixed the package rates for the hospitals for a large number of interventions. Pre-existing conditions are covered from day one and there is no age limit.
- Coverage extends to five members of the family which includes the head of household, spouse and up to three dependents. Beneficiaries need to pay only Rs. 30/- as registration fee while Central and State Government pays the premium to the insurer selected by the State Government on the basis of a competitive bidding.
- RSBY is a Government sponsored scheme for the BPL population of India. Center-State ratio for financing the scheme is 75:25. Government of India’s contribution is 90% in case of North-eastern states and Jammu and Kashmir and respective state Governments need to pay only 10% of the premium.
- State governments engage in a competitive public bidding process and select a public or private insurance company licensed to provide health insurance by the Insurance Regulatory Development Authority (IRDA) or enabled by a Central legislation
- By paying only a maximum sum up to Rs. 750/- per family per year, the Government is able to provide access to quality health care to the below poverty line population.
National Rural Health Mission
- The National Rural Health mission (NRHM) was launched by the Hon’ble Prime Minister on 12th April 2005, to provide accessible, affordable and quality health care to the rural population, especially the vulnerable groups.
- The key features in order to achieve the goals of the Mission include making the public health delivery system fully functional and accountable to the community, human resources management, community involvement, decentralization, rigorous monitoring & evaluation against standards, convergence of health and related programmes form village level upwards, innovations and flexible financing and also interventions for improving the health indictors.
- As per the 12th Plan document of the Planning Commission, the flagship programme of NRHM will be strengthened under the umbrella of National Health Mission. The focus on covering rural areas and rural population will continue along with up scaling of NRHM to include non-communicable diseases and expanding health coverage to urban areas. Accordingly, the Union Cabinet, in May 2013, has approved the launch of National Urban Health Mission (NUHM) as a sub-mission of an overarching National Health Mission (NHM), with National Rural Health Mission (NRHM) being the other sub-mission of the National Health Mission.
Janani Suraksha Yojana
- JSY aims to reduce maternal mortality among pregnant women by encouraging them to deliver in government health facilities. Under the scheme cash assistance is provided to eligible pregnant women for giving birth in a government health facility. Large scale demand side financing under the Janani Suraksha Yojana (JSY) has brought poor households to public sector health facilities on a scale never witnessed before. Target set by MDG for MMR is 109, which seems not achievable in the deadline year of 2015.
Janani Shishu Suraksha Karyakaram (JSSK)
- In view of the difficulty being faced by the pregnant women and parents of sick new- born along-with high expenditure on delivery and treatment of sick- new-born, Ministry of health and Family Welfare (MoHFW) has taken a major initiative to ensure better facilities for women and child health services. It is an initiative to provide completely free and cashless services to pregnant women including normal deliveries and caesarean operations and sick new born(up to 30 days after birth) in Government health institutions in both rural & urban areas.
- Government of India has launched Janani Shishu Suraksha Karyakaram (JSSK) on 1st June, 2011.
Rashtriya Bal Swastha Karyakaram
- A Child Health Screening and Early Intervention Services has been launched in February 2013 to screen diseases specific to childhood, developmental delays, disabilities, birth defects and deficiencies. The initiative will cover about 27 crore children between 0–18 years of age and also provide free treatment including surgery for health problems diagnosed under this initiative.
Total expenditure on health(Private + Public) in terms of GDP:
India - 4.1%
China - 5.4%
South Africa - 8.8%
Kumble inducted into ICCs Hall of Fame
- Legendary leg-spinner Anil Kumble inducted into the International Cricket Council’s (ICC) Cricket Hall of Fame during the World Cup match between India and South Africa in Melbourne
- Kumble will be the 77th member and the fourth Indian cricketer to be inducted into the Hall of Fame after fellow former captains Bishen Bedi, Kapil Dev and Sunil Gavaskar. The legendary trio was inducted into the list in 2009.