India aims to provide universal health coverage to its citizens by 2017, but currently relies heavily on private healthcare due to inadequate public services. Most households pay out-of-pocket for medical care, resulting in over 60% of total health expenditures and increased financial hardship. While various government schemes cover portions of the population, only 17% are insured overall. To achieve universal coverage, India must increase public financing to at least 2.5% of GDP, expand infrastructure and the health workforce, and ensure effective implementation and monitoring of health programs across all areas.

1. CURRENT STATUS AND FUTURE NEEDS
FOR UNIVERSAL HEALTH CARE IN INDIA
INTRODUCTION - Universal Health Care is a systemthat provides quality medical services
to all the citizens. To ensure that all people obtain the health services they need without
suffering any financial hardship when paying for them. This is only possible by the
availability, quality, and affordability of health care system. A strong, efficient, well
regulated health system for providing the need services, supported by the availability of
essential medicines and technologies and a well trained motivated health workforce of
sufficient capacity, and all should be appropriately financed.
India is committed to providing universal health coverage to all its citizens during the 12th
five years plan (2012 - 2017). But majority of health care services in India are being provided
by the private health care sector. According to international institute for population science
and macro international, 57 percent of households have turned to the private health sectors
due to poor quality, lack of infrastructures and unavailability of health care facilities in the
public sector. According to NFHS 3, the private medical sector remains the primary source of
health care for 70 percent of households in urban and 63 percent of rural households.
According to world health statistics 2013, WHO Geneva, on 190 countries, due to lack of
extensive and adequate public health services, a large proportion of the population in India
incurs heavy out of pocket expenditure (OOP). The OOP expenditure as proportion of total
health expenditure is very high,i.e. 61.7 percent in India as compared to the global average
of 20.5 percent. OOP payments push people into- poverty every year.
The availability of health care services provided by the public and private sectors taken
together is inadequate, quality of health care services varying considerably in both the
public and private hospitals are not adequate define and, are ineffectively enforced, and
now a day’s affordability is the serious problem of vast majority of population. According to
WHO the population coverage of various health schemes is respectively Central Govt Health
Scheme covers 3 million people, Employee State Insurance Scheme covers 60 million
people, State Govt Funded Health Insurance covers 110 million people, Rastriya Swasthya
Bima Yojana covers 118 million people, and NRHM covers 800 million people. A 2014 Indian
Government study claimed that only 17 percent of India’s population was insured.

2. The high OOP from the health care sector has led many households to incur Catastrophic
health expenditure(CHE), that threatens a households capacity to maintain a basic standard
of living. Indian government spends below 1.3% of GDP in health sector. This affects the
development of public health sectors very much. In India there is only 1 doctor per 1668
population, and less than 1 bed per 1000 population.
Indian government should focus to overcome this problem. Every single person should
come under some health insurance and provision of free health care for all , because
healthy India leads to wealthy India. Health care should be based on universality, equity,
rational and good quality, affordability, availability, comprehensive care, accountability and
transparency, community participation and putting health in peoples hand. We have to
increase our public financing from 1.3% of GDP to at least 2.5 % of GDP. Developing the
infrastructures, establish new and advanced technologies in hospitals. And we also have to
recruit and train a large number of community health workers such as Nurses, Rural health
care practitioners, Doctors, and Allied health care professionals.
India has many more polices, laws, programmes than any other country, but there is lack of
implementation. There are many hard to reach areas where health facilities can’t reach
properly. So, central and state government should monitor the implementation and
execution of funds in health care.
We have to focus on every levels of care beginning from primordial care and extending to
tertiary level of care including rehabilitation. Encourage community participation, give
health education and effective counselling regarding health and disease. And Equity is very
much important in terms of delivering the health services than equality, that we have to
keep in mind.
CONCLUSION- We are still far away from our goal in universal health coverage. In my term
universal health coverage should be like “ Ensuring equitable asses for all Indian citizens,
residents in any part of country, regardless of the income level, social status, gender, age,
caste or religion to affordable, accountable, appropriate health services of assured quality
(i.e. Promotive, Preventive, Curative, Rehabilitative)”