With the second largest population in the world, India is predicted to surpass the population of China this year. An increase in life expectancy and a gradually reducing death rate over the years have actively contributed to India’s burgeoning population, specifically the geriatric population. In an effort to cope with this growth, public health expenditure has been on a rise since 2014, with an increasing share of the country’s GDP being distributed towards public health care. India’s expenditure on public healthcare stood at over two percent of the GDP in 2022 versus 1.3% in 2020.
As of 2017, the evaluation of the healthcare market of India amounted to approximately 160 billion U.S. dollars and was expected to be 372 billion U.S. dollars by 2022. However, the healthcare system is dominated significantly by private healthcare. Private health outnumbers public health in most aspects, including numbers of hospitals, hospital beds, and doctors.
Universal health coverage
Owing to circumstances that favored the socio-economically advantaged sections of society while the underprivileged remained deprived of timely and affordable medical support, the government proposed a system of universal healthcare in 2015, also referred to as the Ayushman Bharat scheme. With millions of Indians driven towards out-of-pocket health expenses, the government launched a new component of this scheme known as the Pradhan Mantri Jan Arogya Yojana (PM-JAY) in September 2018 – which aimed at providing secondary and tertiary care to the estimated lower 40 percent of the population free of charge. PM-JAY is completely funded by the government and the central and state governments share the administrative and implementation costs of this scheme.
The pandemic was a catalyst for the synergy between the public and private healthcare sectors. Collaborations between the two in areas relative to diagnostics, medical technology and treatment proved to be tremendous. In 2020, India saw a significant increase with close to 50% in private investments and in 2021 alone, the country received investments worth approximately eight billion U.S. dollars, the largest across the South Asian region. Public private Partnerships (PPPs) have been the stronghold of India’s health reforms and also a cornerstone of the National Health Mission. At the primary level, one of the key partnerships has been the outsourcing of the management of PPPs with a non-profit entity to the private sector. This strategy has afforded better outreach and medical access to rural areas.
In order for India to meet its ambitious healthcare goals, there is a pressing need to address and augement funding into the private sector while also leveraging relationships between government and the private sector. Further, devising a national policy to promote prevention, testing and early screening to mitigate disease burden can contribute towards achieving holistic quality healthcare and consequently, overall progress of the country.
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