Subject: Governance

The limitations of India's public healthcare system are evident with government health expenditure at just 1.9% of GDP in 2023-24, significantly below the WHO recommended 5%. This gap presents both challenges and opportunities for alternative healthcare delivery models.

Role of Private Sector in Bridging Healthcare Gap

• Infrastructure Dominance: With 43,486 private hospitals comprising 62% of total health infrastructure, private sector plays a crucial role in healthcare delivery.

• Investment Attraction: Private sector has attracted substantial investments (US$7.7 billion in 2021) enabling technological advancement and specialized care facilities.

• Insurance Penetration: Though currently low at 0.35%, private health insurance coverage is expanding due to regulatory reforms and increased health awareness.

Limitations of Private Sector

• Urban-Rural Disparity: Uneven distribution of private healthcare facilities with concentration in urban areas leaves rural populations underserved.

• Affordability Concerns: High out-of-pocket expenditure makes private healthcare inaccessible for economically weaker sections.

• Quality Variations: Lack of standardized protocols and monitoring mechanisms leads to inconsistent healthcare quality.

Viable Alternatives and Way Forward

• Strengthening Public-Private Partnerships (PPPs):

  • Implementation of Ayushman Bharat through empaneled private hospitals.
  • Collaboration in medical education and research facilities.

• Community-Based Healthcare Models:

  • Expansion of Health and Wellness Centers under National Health Mission.
  • Strengthening ASHA worker network for primary healthcare delivery.

• Technology Integration:

  • Promotion of telemedicine through e-Sanjeevani platform.
  • Implementation of National Digital Health Mission for seamless healthcare delivery.

• Alternative Healthcare Systems:

  • Integration of AYUSH systems with modern medicine.
  • Promoting preventive healthcare through National Program for Prevention of Non-Communicable Diseases.

The path to universal health coverage lies in a balanced approach combining public sector expansion, private sector regulation, and innovative healthcare models. Success stories like Kerala's decentralized healthcare and Tamil Nadu's urban primary healthcare demonstrate that contextual solutions with strong governance can effectively address healthcare gaps.