Healthcare regulator mooted, increased public spend to slash out-of-pocket expenses

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January 30, 2021 1:30 AM

Despite the quality of treatment in the private sector not being “markedly better” than the public sector, the Survey pointed that the costs of treatment are “uniformly higher” in the private sector.

Around 74% of outpatient care and 65% of hospitalisation care is provided through the private sector in urban India.Around 74% of outpatient care and 65% of hospitalisation care is provided through the private sector in urban India.

An increase in public spend on healthcare to 2.5-3% of GDP – as envisaged in the National Health Policy 2017 – could decrease the Out-Of-Pocket Expenditures from 65% to 30% of overall healthcare spend, the Survey noted, even as there are wide-spread expectations that Monday’s Budget will enhance the spending on healthcare like never before. The Covid-19 vaccine roll-out programme alone is expected to cost the exchequer Rs 25,000-30,000 crore.

The survey has suggested the introduction of a healthcare-sector regulator to improve the quality of services. It has also prescribed the formation of rating agencies to assess the quality of the healthcare providers which will spread awareness about prices and quality of services.

“To enable India to effectively respond to future pandemics, the health infrastructure must be agile. Second, given its potential to provide healthcare access in remote areas, telemedicine needs to be harnessed to the fullest by especially investing in internet connectivity and health infrastructure. Third, the National Health mission has played a critical role in mitigating inequity as the access of the poorest to pre-natal and post-natal care as well as institutional deliveries has increased significantly,” the Survey said.

The Centre has also been asked to stick to its 2017 plan to increase the expenditure on healthcare, as a percentage of the GDP, to as much as 3%. The share had inched up to 1.8% in FY21 (budgetary estimate) from 1.5% in FY20. India ranks 179th out of 189 countries in prioritisation accorded to health in its government budgets.

“A standardised system for quality reporting on healthcare for hospitals, physicians and insurance companies can start with basic input indicators to be reported mandatorily by every healthcare stakeholder,” it added. The government can utilise data from the national digital health mission and use artificial intelligence and machine learning algorithms to reduce “information asymmetry” in healthcare, “which creates market failures and thereby renders unregulated private healthcare sub-optimal,” the Survey stated.

Despite the quality of treatment in the private sector not being “markedly better” than the public sector, the Survey pointed that the costs of treatment are “uniformly higher” in the private sector. Around 74% of outpatient care and 65% of hospitalisation care is provided through the private sector in urban India. India ranks 145th out of 180 countries in terms of on quality and access of healthcare. Hospitalisation rates of 3-4%, reflecting lower access and utilisation.

The Survey has also advocated harnessing telemedicine facilities to improve healthcare services. eSanjeevani OPD (a patient-to-doctor tele-consultation system) has recorded almost a million consultations since its launch in April 2020, while Practo has mentioned a 500% increase in online consultations in just three months, the report noted.

To avoid “saliency bias”, which involves over-weighting recent phenomena like the Covid-19, the survey suggested that the healthcare system should not have a specific focus on communicable diseases. Between 1990 and 2016, the share of deaths due to non-communicable diseases increased from 37% to 61%.

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