New Delhi: The Congress party-led United Progressive Alliance’s (UPA) government’s health sector reforms, including an ambitious plan to roll out universal health coverage (UHC), have been stalled because of a shortage of funds.
The UHC programme will now be restricted to a few districts where the scheme will be tested. It will be initially rolled out in 10 districts before further expansion, according to at least three officials familiar with the development.
The government had planned to increase spending on public health to 2.5% of the gross domestic product (GDP) to make healthcare affordable and accessible under the 12th Five-Year Plan (2012-2017).
The National Development Council, the top decision-making body on development issues in India, has approved health spending equivalent to 1.85% of GDP in the period. The National Advisory Council (NAC), led by Congress party president Sonia Gandhi, which drafted the terms of references for the universal health plan in September, is working closely with the stakeholders, including the health ministry and the Planning Commission,to recommend an approach for piloting the universal health coverage policy at district level.
A member of NAC said a cash crunch would affect the implementation of the healthcare programme.
“There is no money,” this person said on condition of anonymity. “The health ministry is likely to get 15% over the revised estimates which would mean only an actual 5% increase since last year’s budget. At a 5% increase, there is only as much you can do and UHC will get hit by this.”
The UHC is one of the government’s key public welfare programmes, which seeks to make access to healthcare an entitlement for every citizen.
While the health ministry has expressed its reservations about implementing the plan because of financial constraints, a senior official in the Planning Commission said the programme will have to be implemented within the available means.
“The health ministry will always find the budget limited. The issue is not about increasing allocation but making optimal utilization of what they have. The UHC programme will not be implemented at the central level, but the health ministry officials are not yet in dialogue with state governments to chalk out plans for implementation,” the person said. He also didn’t want to be named.
The UHC is aimed at bringing together state-level health insurance schemes and the Rashtriya Swasthya Bima Yojana, or national health insurance scheme, under a single framework.
“The government needs to spell out a clear-cut policy, in addition to the in-principle agreement, to implement UHC,” said Srinath Reddy, chairperson of a high-level expert group set up by the Planning Commission to recommend a framework for the implementation of UHC. “I would like to see concrete measures for initiating the policy and progressive implementation. The plan document mentions UHC, but how it will be followed through is not clear.”