Road Map to Universal Health Coverage Dr Girdhar Gyani DG- AHPI

What is UHC? Availability Accessibility Affordability Acceptability “UHC offers financial protection to an individual during illness, reducing out of pocket expenditure”

Financial Protection Globally around 150 million suffer severe financial hardship/catastrophic health expenditure every year 100 million are pushed into poverty because they must pay out-of-pocket at the time they receive health services. *Source-WHO

WHO Recommendations Raise sufficient funds for health Reduce heavy reliance on direct out- of-pocket Reduce & Eliminate in-efficient use of resources

Health Financing Data (2013) CountryTotal Expenditure on Health as % of GDP Pvt Expenditure on health as % of total expenditure on health Govt expenditure on healthcare as % of total govt expenditure India4%67%4.5% Thailand4.6%20%17% Malaysia4%45%6% China5.6%44%12%

INDIA in 2015 World Bank Report says that 630 million Indian population (50% of total) was being covered. Out of this RSBY alone provides cover to about 200 million population Central government schemes- CGHS, ECHS, ESIS cover about 100 million population.

States operating with govt. insurance for Health: S. No State Health budget (in Cr) Per capita spend of Health Budget (in Cr) Amount of Health Budget spend on Insurance schemes 1 Andhra Pradesh Cr 2 Telangana Cr 3 Tamil Nadu Cr 4 Karnataka Cr+ 140 Cr 5 Gujarat Cr 6 Maharashtra Cr 7 Rajasthan Cr

States not operating any govt. insurance for Health: S. No State Health Budget (in Cr) Amount of Health Budget Spend per person(in Cr) Amount of Health Budget spend on Insurance schemes 1 Uttar Pradesh *NA 2 Bihar *NA 3 MP *NA 4 West Bengal *NA

Road Map to UHC 7 States provide UHC for BPL families with about lakhs per capita spent on health Central/State Govt. need to raise per capita allotment on health for remaining states to minimum of 7- lakhs to have UHC Government can strengthen RSBY to raise limit from Rs. 30,000 to 100,000 Government can also explore micro financing schemes like YASHASWINI.

Road Map to UHC contd... Government insurance schemes are successful, as patients are getting cashless and quality care from the empanelled private hospitals. This also saves government from investing in health infrastructure. For UHC in rural areas, we may rope in private sector to operate some of the CHCs/PHCs. Government can also float schemes with provision of co-payment for APL categories.

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