New Delhi: India faces health care challenges, including a decline in the role of public delivery of health services, high out-of-pocket (OoP) expenses of households and accessibility and affordability of medical care, according to the second volume of the Economic Survey 2016-17, which called for a mandatory shift to generic drugs.
Private doctors are the single most important source of treatment in both rural and urban areas, the survey said, citing the National Sample Survey’s (NSS) 71st round (January 2014 to June 2014)
More than 70% (72% in the rural areas and 79% in urban areas) of the spells of ailment were treated in private sector which entails higher out of pocket expenses in comparison to those treated in public health facilities.
“India has emerged as the country with the largest OoP expenditure on health, among BRICS (Brazil, Russia, India, China, South Africa) economies, consistently higher at more than 60% since 2008. While in developing countries like Brazil, the percentage of OoP expenditure is less than 32%, in South Africa, it is less than 10%," the survey said.
“The higher OoP expenditure on health leads to impoverishment of poorer sections of society and widens inequalities. OoP expenditure for poor is a double whammy because, one, adverse health conditions impact their productivity and ability to earn their daily incomes and, second, payments to get themselves treated adds to their financial distress and impoverishes them," it said.
The survey emphasized that it is necessary to expand provision of quality public health services to low income groups to prevent the impoverishment of large sections of the population owing to ill health.
“The patent drugs and medicine providers in India are large players, enjoy a monopoly position, and so make excess profits at the cost of the consumer. This position needs to be countered in several ways. First, the government and public purchases need to mandatorily shift to generic drugs to reduce demand for patented drugs and cost to the government," the survey report said.