Health care Reforms - post two years of new governance

I am not a great fan of the present regime of governance at the center.The way the representatives of the government has hijacked the patriotism and sentiments of the common man to the arrogant espousal of religious ideas which has no tolerance to various worldviews has caused a deep concern in the common man and has caused a dent in the integrity of the people and politicians who run the constitution.Amidst the proceedings the government feels it has done enough groundwork to put the nation back in the development path.The way it tries to open the champagne too early is revealed in its pompous demeanor adopted for celebrating the two years of being at the helm of affairs.I was left wondering about the health care reforms brought about by this regime which would pave way for the better tomorrow of the common man.Has it really happened?Can development occur without taking into account the health of its recipient?Let me put down some thoughts on it.I am just putting forth my understanding on various issues after some basic research and readers can correct me if i am wrong on the facts presented

WHERE IT SCORED.......

1.Health care as a fundamental right:

In India health care is not a fundamental right.Though there are various laws and judgements regarding the legal aspects of the duty of the state and central governments to provide for the health of common man still the common is left at the mercy of the private health care provider.The draft National policy of health released by the NDA government in 2014 was a welcome move at this juncture.What stood out in the discussions which ensued was a renewed interest in viewing healthcare as a right to the individual and making health care as a justiciable act(meaning you can sue the state if it fails to provide appropriate health care to you!...wow!!).Also what was commendable was the thrust given to universal health coverage(UHC).The previous government was partly successful in its objective by rolling out the RSBY(Rashtriya Swasthya Bhima Yojana) which was instrumental in meeting the health care needs of the below poverty line families in various parts of the nation.But it did not  create a huge impact on the health care delivery as it had to face many teething issues .Thanks to the greedy corporate third party providers and the crooked health care professionals!To me this move by the NDA government to provide UHC is a great move.Though many criticise questions the intention of the government at least it had the guts to put it on paper and start the thousand mile journey with a single step!
It would be interesting to watch how the government rolls out its ideals to the common man and translates its promises to reality.

2.National Dialysis Service Programme:

In the runup to the budget for 2016 and 2017 the finance minister Mr Arun Jaitley announced that Dialysis centers will be set up in all districts of the country.What was interesting according to me was this was a first time where an official announcement is being made where a tertiary health care service is being brought to a secondary care level.I believe its a different road map where previous efforts have been fully concentrated in strengthening the existing tertiary centers rather than decentralising them.Of course more needs to be done in terms of delivering the promises and the challenge of bringing qualified healthcare persons to nook and corner of the country is herculean in nature.

3.Low cost Pharmacy stores:

This is a very interesting initiative by the government in providing generic medicines at affordable costs to the citizens.About 3000 stores will be opened up in various parts of the country to meet the drug demands of the patients and citizens.The focus given for generic medicines isa welcome move though caution has to be exercised regarding the quality of it when it has to be manufactured and distributed at a larger scale.I hope more and more institutions will take up the responsibility of being a service provider for these drugs.Also if teh scheme becomes successful it will make a dent in teh income of the major pharma companies who ride on their profit from patented medicines.In indian mentality anything "branded " is superior which has resulted in soaring up of prices for essential goods such as medicines which eludes the reach of common man.

WHERE IT FAILED.....

1.No major startegy for primary health care interventions:

The government has not made any strategic plans to address the rising inequalities in access of the common man to primary health.The Urban and rural health care access is still divided and wide and the concentration of health care resources on urban areas in increasing day by day.A policy or direction which does not include a strong primary health care intervention cannot be labelled as a inclusive comprehensive policy which will change the fate of a nation.We can only ignore primary health care at our own peril!

2.Cut down on budget:

Government has decided to cut down on the allocation to health in the budget by 20% which is seen as a set back to the various existing schemes run by the government.Though the rationale given by the government is that it is doing so only for non performing schemes, no clear policy direction has been formulated to generate income for the new schemes which has been announced or for the sprucing up of the old schemes in productive ways.Already compared to the developed and developing nations India spends less than 1% of its GDP for health and decisions like these is just a slap on the face for escalation of healthcare interventions in India



3.Health Education and access:

The health education sector is in shambles in India:The lack of quality education leading to substandard health practioners and the lack of a strong regulatory body to oversee the health education in our nation has been overlooked by previous governements.So far this governement has also been on the defensive not taking any concrete steps to address the issue.The concentration of health care personnel resources in urban areas has led to the injustice meted out to the common man in the periphery.The goverment should make mandatory guidelines for rural postings to address the issues atleast for people who milk the governement system for their own profit by training in government colleges.The minority instituitions which do so diligently by sending their graduates to rural parts of the country are overlooked and repeated interference is made in their admission process and autonomy.This situation has to change for the betterment of of the whole medical community.



4.Wholistic care:

will this be the status of our future generation??

Health of an individual in interrelated to the environment in which he lives and there is no strategy to address the collapse of the ecology around the indian citizen which is compounded by the industrialisation and urbanisation.For example Delhi was found to be the most polluted city in India prompting the government to take knee jerk measures such as the banning of diesel vehicles and odd even rule.But the immediate health impacts of this pollution to the present generation is not being actively debated and pollution is debated in isolation as "discomfort" but not as an assault on the right of the individual to breathe in a free pure air for his health.Waterbodies are being dried up and farmers are committing suicides.The relation between healthcare and socioeconomic status is well established fact.How does health care security comes into play in this setting?God has given us this stewardship of earth as well us our bodies and healthcare has to be approached interdependently rather than only in "disease and cure"mode by the government.


My sincere hope and prayer is that the government will wake up to its responsibility of providing universal health coverage to its people in a more comprehensive way.Vandalism by private health care should be stopped and rural healthcare should be upheld for equitable care.

If this dream becomes a reality ,one day mission hospitals will vanish from India!!