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The Union health ministry’s plans to extend the National Health Mission to 2020 point to the confusion in India’s healthcare policy. The ministry has trimmed cost estimates after criticism by NITI Aayog and the finance ministry about inefficiency. This is a conundrum. On the one hand, the Comptroller and Auditor General’s report on National Health Mission, which points out the wastage of available equipment because of the lack of trained personnel, shows the criticism is valid. On the other, there is a pressing need to increase healthcare spending alongside efficiency.

The National Health Mission plans also have other problematic aspects such as the goal of reducing prices of drugs and medical devices. The government’s attempts in this direction have been clumsily counterproductive. Meanwhile, NITI Aayog’s attempt to address the need for synergy between the public and private sectors, with its proposal to allow private firms to lease space in government hospitals, has plenty of question marks over it and has garnered little enthusiasm from the central and state governments. The Gorakhpur tragedy has shown that such confusion in healthcare has high costs.

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