We believe that implementing UHC has more to do with political will, social solidarity and effective governance than the ability of the state to ensure sustainable funding.
The evolution of health care will closely mirror the economic development of the country. Assuming that the average GDP growth of 7% witnessed over the last few years continues for the next decade as well, key factors that will decide the success of UHC program are as follows:
1. Focus on health outcomes: It is critical to calibrate the aspiration of UHC and the enhanced spend on health care, with an equally sharp focus on improving health outcomes.
This is necessary not only to limit any wasteful expenditure but also ensure that focus is on health and not merely sickness. Key levers for focus would include:
- Reducing disease burden through a robust and functioning primary care system, including prevention, early detection and out-patient care
- Quality of in-patient care
- Integrated approach
2. Taking care to where the patient is: It is critical to ensure adequate generation and equitable distribution of supply of health services under a UHC program. Key levers for focus would include:
- Filling the physical and human infrastructure gap
- Integration with other schools of medicine
- Technology-enabled healthcare
3. Ensuring strong focus on cost of care: To ensure that the financial burden of an UHC is managed effectively, the UHC regime demands a strong culture of cost consciousness. Key levers for focus include:
- Drug price policy and generic adoption
- Indigenous medical technology
- UHC reimbursement rates
- Administrative costs
4. Enabling governance: An effective and efficient UHC regime demands optimal health system governance that ensures transparency, defines the appropriate levels of checks and balances to secure integrity of delivery and provides granular epidemiological data for evidence-based decisions. Key levers for focus include:
- Centre-state role and accountability
- Use of technology for transparency and managerial effectiveness
5. Building centers of excellence (CoE): The adoption of UHC as a policy imperative will entail providing access and affordability to all in the short and medium term.
Advancement of care will also be an equally important imperative to attain UHC in the true spirit. This will necessitate seeding investments to build CoE for medical needs that are relevant to Indian epidemiology and in designated geographic zones that are accessible to all for the most complex of care. This will help the country attain medical and research excellence.
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