Govt target of 2.5% by 2025 is low compared to China which spent 3.1% in 2014 and 2.0% in 2007 (see link B). India spent just 1.4% in 2014, though on a rising trend. With greater efficiencies, decent universal health care can be possible with 2.5% of GDP.

Karan Singh, MD Bain India comments on the new Health policy (2017)
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The government is doing the right thing: it is not focusing on near-term electoral gains and is positioning health as a national priority by backing it with greater spending. The proposed blueprint is targeted, sensible and comprehensive. Significantly, the policy takes a holistic view of the health system and achieving better outcomes across elements of access, cost and quality—all are closely inter-related. There is also a commitment to increasing public spending on healthcare to 2.5% of GDP.

Preventative care is very cost effective
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The health policy has sensibly focused on preventive care and health living and is trying to fundamentally change the paradigm from sickness to wellness. This is the need of the hour as it cost-effectively improves outcomes. It is also great to see the focus on outcomes such as life expectancy and disease-specific targets. We have missed achieving millennium development goals in infant and maternal mortality, and, if we don’t address the epidemic of non-communicable diseases, our growth potential will be gravely undermined.

Primary care is vital - needs better information exchanges

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Today, we are significantly under-consuming wellness: We need to encourage a behavioural shift towards consumer wellness. Even in urban India, the average number of outpatient/ inpatient visits is low. An abundance of linkages across primary and secondary care, information sharing, alignment of incentives across the private and public sectors and different healthcare sub-sectors needs to be brought about.

Access for under-served - needs private sector and infra building

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The policy looks to increase access by expanding coverage to the underprivileged and under-served and focuses on primary healthcare packages with geriatric, palliative and rehabilitative services. It also looks at increasing hospital beds to 2 per 1,000 people from an appalling 1.3 in 2012. We will see a non-linear scale-up across the system—doctors, nurses, primary care infrastructure, district hospital infrastructure—all of which are woefully inadequate. Also, a critical factor to ensure healthcare delivery to all is the issue of how the private sector can engage with the government to create a sustainable model for health and financial outcomes since government health infrastructure has not delivered. This is especially important, given that nearly 80% of the current infrastructure is private-driven. 

Quality requires talent and a total management upgrade

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The policy also focuses on quality, recognises the role of the private sector and envisages the creation of a public health management cadre to optimise health outcomes. We will see an acceleration of quality grading of establishments—something that is at abysmally low levels today.  Talent is a constraint at multiple levels and acceleration of capacity is critical to driving access, which the emphasis on affordability alone will not solve.

Use of digital technologies: Finally, it has encouraged digital usage in its vision of Aarogya Bharat. So let’s applaud the government on its thinking and come together to help usher in a new and more sustainable paradigm for healthcare for Aarogya India that will benefit us all.
Finally, health policy for all of India March 2017