Just as India gears up to roll out Ayushman Bharat on September 25, a group of international health experts including former UN Secretary-General Ban Ki-Moon on Thursday called it "unbalanced and too skewed towards costly inpatient care." It also urged India to put "more political will" and push public financing in the health sector to achieve universal health coverage (UHC) in the country.
In its report "Universal Health Coverage in India" released on Thursday here, The Elders, a London-based organisation of independent global leaders , while welcoming Ayushman Bharat which has two components-insurance to poor families and setting up wellness centres, however cautioned that "taking into account economic growth, inflation and population increases, real per capita public health spending as a share of GDP has hardly changed."
India is therefore not yet on a a trajectory to meet the government's own target of 2.5 per cent GDP public health spending by 2025, the report noted.
"We are concerned that Ayushman Bharat is unbalanced and too skewed towards costly inpatient care. Greater focus should ne given to the free primary healthcare services provided at health and wellness centres and integrating these with services covered by the National Health Protection Scheme.
"Also, it would appear that the NHPS is repeating the design flaw of the RSBY in not protecting people from outpatient costs, including medicines which make up 70 per cent of India's out of pocket expenditure," said the report by The Elders, founded by Nelson Mandela in 2007.
The health experts have suggested the government to invest the bulk of its additional public health funding in providing comprehensive, free primary care services to the entire population. This would be more efficient and equitable route to UHC in India.
Ban who is in India, as part of a delegation said, "I am here with a single purpose, with a single agenda and that is to promote universal health coverage and overall health aspects. The Indian government has planned to spend 2.5 per cent of the GDP by 2025.
"And, it is hoped that India will push much further investment and more money, and more political will by Prime Minister (Narendra) Modi, and chief minister and health ministers (of various states)," Ban said during a panel discussion here.
Besides Ban, former Norwegian Prime Minister and former Director General of the WHO Gro Harlem Brundtland, President of Public Health Foundation of India Dr K Srinath Reddy and NITI Aayog member Dr V K Paul were in the panel.
Paul, however, rejected the apprehension saying that the Government has ensured sufficient funds like introduction of cess to meet the financial needs for the scheme.