Horses for Courses: Moving India towards Universal Health Coverage through Targeted Policy Design

Maurya, Dayashankar and Virani, Altaf and Rajasulochana, S (2017) Horses for Courses: Moving India towards Universal Health Coverage through Targeted Policy Design. Applied Health Economics and Health Policy, 15 (6). pp. 733-744. ISSN 1175-5652

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Abstract

he debate on how India’s health system should move towards universal health coverage was (meant to be) put to rest by the recent National Health Policy 2017. However, the new policy is silent about tackling bottle- necks mentioned in the said policy proposal. It aims to provide universal access to free primary care by strength- ening the public system, and to secondary and tertiary care through strategic purchasing from the private sector, to overcome deficiencies in public provisioning in the short run. Yet, in doing so, it ignores critical factors needed to replicate successful models of public healthcare delivery from certain states that it hopes to emulate. The policy also overestimates the capacity of the public sector and down- plays the challenges observed in purchasing secondary care. Drawing from literature in policy design, we emphasize that primary, secondary and tertiary care have distinct characteristics, and their provision requires sepa- rate approaches or policy tools depending on the context. Public provisioning, contract purchasing and insurance mechanisms are different policy tools that have to be matched with the context and characteristics of the policy arena. Given the current challenges of India’s health sys- tem, we argue that tertiary care services are most suit- able for insurance-based purchasing, while the public sector should concentrate on building the required capaci- ties to dominate the provisioning of secondary care and fill gaps in primary care delivery, for India to achieve its universal coverage ambitions.

Item Type:	Article
Uncontrolled Keywords:	Universal Health Coverage;Health Policy Design
Subjects:	?? Healthcare_Management ??
Divisions:	Health care Management
Depositing User:	Mr. Muralidhara D
Date Deposited:	12 Sep 2018 13:35
Last Modified:	12 Sep 2018 13:35
URI:	http://tapmi.informaticsglobal.com/id/eprint/78

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