Universal Health Coverage: Access to good health care services to poor

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Universal Health Coverage: Access to good health care services to poor

Thursday, 12 December 2019 | Dr BKS Sanjay

Universal Health Coverage Day is commemorated each year on December 12. Universal health coverage is promoted as an instrument to help advance the more broadly conceived human right to health, which is based upon a number of international agreements, or widely affirmed international documents.

Under the United Nations Sustainable Development Goals, all UN member states have agreed to try to achieve universal health coverage by 2030. This includes financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

The theme of World Health Organisation for this year is universal health coverage. Universal health coverage day is celebrated and is promoted by the World Health Organisation to provide affordable, quality health care by all nations to their citizens.

Every person irrespective of caste, creed, race, region, and religion needs health, education and nutrition for growth. Indian scriptures mention that all should be healthy and disease free and none should suffer in any way.

A Chinese philosopher once said that health is the biggest right. According to an Arabian proverb where there is health, there is hope and where there is hope, there is everything. The Romans believed that prevention of illness was more important than cure of illness. Hence, good health should be the highest priority of all mankind.

Although progress is being made by countries in all regions of the world, millions of people still have no access at all to health care. Health is not only an asset but a resource too. But, our experience shows that health need is being pushed to a secondary position on several occasions especially in poor and developing countries like India. It is said that a sensible person never kills the hen which lays golden eggs.

But our society and the Government are killing it. What is HEN? H stands for Health, E for Education and N for Nutrition. The troika of health, education and nutrition is being driven in a haphazard and in an uncoordinated way in our country.

It is important for government and individuals to look after the health of all people to make them more stable and strong to complete any task easily and quickly. The WHO is focusing on universal health coverage, so is our government.

It is not only my experience but I am sure it may be your experience as well that in India the health needs of most of the people are competing with the basic human needs like food, shelter and education. In India, we are still not realising the importance of good health and the government is still figuring out how to keep our fellow countrymen healthy.

 To achieve this goal the Government of India has implemented Ayushman Bharat Yojana. The main aim of this programme is to improve health care service for the poor people of whole country. The money will not be any problem for these needy and poor people to obtain good health care, if the situation arises.

The WHO asserts, following countless studies, that nations which invest in universal health care make a sound investment in their human resource. Access to affordable health care will not only truly improve someone’s health and life expectancy, but will also reduce poverty, create jobs and drive economic growth of the nation.

The UN has adopted 17 sustainable development goals for eliminating poverty. One of the goals includes providing universal health coverage. The global coalition of hundreds of organisations in 116 countries has urged the governments to make the policy changes in governance so that everyone, everywhere can access quality health care without been forced into poverty.

Health, education and nutrition are the basic foundation stones of any individual and of the nation. The importance of universal health coverage is been emphasised all over the world by many organisations to give affordable health care services to the all people.

The Government of India has started Ayushman Bharat Yojana, Pradhan Mantri Jan Arogya Yojana or National Health Protection Scheme which will cover 10 crore poor families or approximately 50 crore beneficiaries providing coverage up to Rs five lakh per family per year for secondary and tertiary care hospitalisation. This scheme provides cashless benefits from any public or private empanelled hospitals across the country.

After implementation of this scheme, the cost of treatment which usually deprives the poor patients from accessing good affordable health care will not be a problem if the situation arises. If this scheme is implemented honestly then it will be a milestone in health care services of India.

This scheme is accepted and being implemented all over the country accepts four states - Delhi, Odisha, West Bengal and Telangana. Millions of people have been benefited from this scheme till date.

However according to many mass media reports, the widespread misuse of this scheme has been reported particularly by the private doctors and hospitals generating the fake bills. Nearly 3000 fraud cases have been detected till November 2019 under Ayushman Bharat Health Insurance Scheme according to national mass media reports.

The bills have been generated either doing the surgeries on ghost patients or doing the multiple surgeries in same patient or showing the fake ICU (Intensive care unit) admissions and in many other ways. There had been at least 697 fake cases under this scheme from our state Uttarakhand alone, where fine of more than Rs one crore has been imposed on these fraudulent hospitals. The health facilities in our country are not very well evenly spread all over the country. But in general the health facilities are more concentrated in urban and in plain areas. There are places in the country especially in hilly and remote areas where one cannot get the average quality health services.

If at all they are available then they are available at far away and they are relatively expensive for these poor peoples. All these three- health, education and nutrition are interrelated. We need money to achieve them but money can only be earned when person is healthy. If you are not healthy then you have to spend all earned money to gain the health. In such a scenario everybody should be health conscious.

In India health facilities are not comparable to the any standard of a developed nation. In India, 50-70 per cent of the hospital expenses are borne by the patient even in government funded hospitals and almost 100 per cent from their pocket in private hospitals.

 It is not only in our country that medical treatments are becoming expensive because in developed nations it is even more expensive. In our country most of the people are getting the treatment after selling their assets like jewellery, land, vehicle, animal and house.

Once it is sold it is difficult to buy back especially if the person is poor and unemployed. Ayushman Bharat Yojana is a step to improve health care services in India particularly for poor people. Considering the socio-economic conditions of the nation, all of us stakeholders should work collectively to make the Ayushman Bharat Yojana successful nationwide.

(The author is an orthopaedic and spine surgeon, and the founding president of State Chapter of Indian Orthopaedic Association)

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