Costly affair with health services

BHUBANESWAR: Access to free and affordable medicines and vaccines would not only be key to achievement of Universal Healthcare Coverage (UHC) by 2022 but also play the central role in controlling infectious and non-communicable diseases along with countering emerging public health threats, the High Level Expert Group (HLEG) on UHC said on Thursday. Public expenditure on health is looking at a significant jump from the current 1.2 per cent to 2.5 per cent of the  GDP in the 12th Plan and three per cent of GDP by 2022 following adoption of the HLEG report by the Planning Commission. The vision of UHC is to extend mandatory health entitlement with guaranteed access to primary, secondary and tertiary care for every citizen by 2022. In India, 78 per cent of individual expenditure on health is out-of-pocket and almost 74 per cent of that spending is on drugs and medicines. “People borrow money for medicines. Most disturbing is the fact that millions of people are being pushed to below poverty line (BPL) on account of disease and health spending,” Chairman of the Group Prof K. Srinath Reddy said. The HLEG has recommended a complete overhaul of the drug policy and institution of Standard Guidelines for reining in the menace of high pricing, presumptive prescriptions and flooding of irrational, non-essential and even banned formulations. The empowered group has called for enforcement of price control on essential and commonly prescribed drugs. “Along with establishment of national and State-level drug supply corporations, the Government should also consider setting up of a warehouse in each district to ensure availability of drugs to all providers,” Prof Reddy added. The HLEG has sought transfer of the Department of Pharmaceuticals from the Ministry of Chemicals and Fertilisers to Ministry of Health and Family Welfare. By doing so, both drug manufacturing and price control would be under a single authoritative body and thus be more effective and accountable. The HLEG has also emphasised abolition of “Users Fees” in hospitals and public health facilities. Experience worldwide has proved counter-productive as even very low fees has shown negative impact on usage of health services. General taxation should be used as principal source of health financing, member of the National Advisory Council (NAC) headed by Sonia Gandhi, Dr AK Shivakumar said. “The Planning Commission is studying the report and we expect drastic changes in public health sector and announcement of the National UHC Policy for the 12th Plan period,” he told this paper. Both Prof Reddy and Dr Shivakumar along with  Dr Manish Kakker, Dr D Prabhakaran of Public Health Foundation of India, Prof Vinod Paul of AIIMS, New Delhi, and Dr Mirai Chatterjee of SEWA, Ahmedabad, attended a seminar on ‘Reconfiguring the Health system for UHC’, chaired by State Health Secretary Anu Garg at the 99th Indian Science Congress here.