2. Healing Touch: Universalizing
access to quality primary healthcare
A model to fill in the loop holes while strengthening
strengths of the system
OUT OF POCKET
1.Introduction-The worlds largest insurance scheme run
by the government. Run by the ministry of labor and
employment. BPL and other disadvantaged groups
covered. Government pays the premium. Operation done
via distributed biometric cards.
2.Positives- 27 states covered,12000 hospitals included.
Technology based (Biometric cards issued).
3.Drawbacks- As premiums paid by government the
number of claims have increased making scheme
unviable in future. Only 10% of BPL families
covered. Hospitals performing procedures profitable
to them and cherry-picking customers.
Existing policies by the Government: A Review
1.Introduction-Run by the Ministry of Health. Formed to
improve health delivery in rural areas.
Healthcare delivery via trained local residents3called
as Accredited Social Health Activists (ASHA).
2.Positives- (2a,2b)- Improvement in healthcare
indicators for short time, service at doorsteps via
efforts like ASHA.
3.Drawbacks- Later stages of scheme marred by
scams, corruption, virtually non functional due to
inadequacies of the Panchayat Raj.
• Should include all citizens of India
below poverty line.
• Rashtriya Swasthiya Bima
• Yojana is a good example.
• Expansion of scope penetration,
viability and proper audit needed.
Need national insurance plan
Increase coverage of
RSBY by including
which constitutes 90%
of healthcare. Also get
them registered under
clinic and registration
of these clinics.
This will also
Subsidize clinics, health
sectors and pharmacies .
To avoid over prescription of drugs and
procedures by the hospitals, upload
diagnosis and treatment online.
Random computer picked cases( like
one done in lottery) to be audited each
day by expert panel of doctors.
This will also create data repository .
clean water supply
awareness etc. Set up
penetration of scheme
formation of new
1. REDUCING OUT OF POCKET EXPENDITURE
• 1.Encourage private players to set up clinics. Tax exemption to these players. These
clinics will be equipped with alternative forms of medicines like allopath, ayurveda,
unani etc. Treatment for primary ailments should be standardized for various forms
of medicines. Standardization and integrating all forms of medicine to be done by
an expert panel. At least any one form should be available. This will solve the
• 2.These clinics will be equipped with mobile pharmacy to reach remotest of places.
This mobile clinic shall be present at weekly markets accompanied by a healthcare
3. Dispensing will be done in fixed standardized containers ( no loose containers) to
prevent fraudulent usage. Dispensing should be done via biometric card to ensure better
monitoring. Make data on biometric card available online to all. Dispensing done via
barcode scanners linked to biometric cards. The system will be identical to the ne used
at malls currently.
3.CREATING ADEQUATE HEALTH FORCE.
Courses can be availed by the rural
people for free or at a very
The clause being that they have to
serve in the rural area for a specific
period of time after successful
completion of the course. (such a
system is carried out within army
Special emphasis on rural health
Give them a government recognized
certificate on basis of experience and
They will work under doctors and
pharmacist. They will report to them.
Creation of new colleges in rural
Empower ASHA workers which re
are a part according to the NRHM
4. FOSTERING LOCAL INNOVATION IN HEALTHCARE
• Innovations in Healthcare which will bolster achievement of MDG can be done by-
• Integrating the effort taken by various ministries (e.g. Ministry of Health, ministry of labor and employment
• Expanding scope of Indian Council of Medical Research. Creating separate divisions for rural health
• Collaboration of all its national centers and discussion on common problems.( e.g. National Institute of
Occupational Health, Research in Tuberculosis (NIRT), Epidemiology (NIE), Pathology (NIP), etc)
• Integrating the National Innovation council with all these efforts.
• Empowering organizations such as the honey bee network which work in exploring novel jugaad solutions
• Integrating college courses in these fields.
• Inviting private giants to partner and market innovations on a large scale.
ESTIMATED COST FOR PROGRAMMES
-Creation of clinics(stationary &
-colleges & institutions
-ASHA workers and training
- Medicines and diagnostic instruments
-IT Hardware cost
-IT Software cost
-Distribution, authentication of
-transport of medicines.
-selection of clinics and their
Chief Controller Manages whole
All responsibilities to be relayed and divided according to area.
• (2a)-Peter Berman and Rajeev Ahuja (2008). "Government health spending in India". Economic and
Political Weekly 46. pp. 26–7
• (2b)- Ajay Mahal, Bibek Debroy and Laveesh Bhandari (2010). India Health Report 2010. Business
Standard Books. p. 138. ISBN 978-93-8074-000-3
• (4)- http://www.napsipag.org/PDF/RUMKI%20BASU.pdf