THIRUVANANTHAPURAM: With Kerala spending the highest “out of pocket” expenditure on health and the spectrum of diseases in the state changing from communicable to Non-Communicable Diseases (NCDs), the Kerala State Planning Board has called for ensuring financial risk protection mechanism and to give emphasis to prevention of non-communicable diseases.
With the spectrum of diseases changing to chronic diseases, especially cardiovascular disease, diabetes, cancer and hypertension, the finances of the common man have come under stress, according to a report of the Planning Board Expert Committee on Health that has been circulated to Ministers, MLAs and MPs. The committee was formed to deliberate on the various challenges faced by the State’s health system and the strategies to be adopted during 12th Five Year Plan.
The expert committee has recommended ensuring financial risk protection to the people, strengthening primary care service delivery and strengthening service delivery of public hospitals through innovative finance mechanisms for bringing down the health expenditure and preventing the risk of various non-communicable diseases.
According to the report, the health expenditure in Kerala is highest in terms of both public (Rs 287) and private health expenditure (Rs 2663) in India. It also quotes the latest study conducted by KSSP that shows that on an average, a person spends almost Rs 6,000 an year out of his own pocket. The study said that the main reason for the high expenditure was due to the increase in the number of people suffering from chronic diseases and recurrent expenses of treating these diseases.
The committee recommends strengthening of primary health care system as one of the steps to reduce expenditure. “At present the focus of primary health care has remained on maternity and child care services. This should be extended beyond this,” the report said. Apart from this, the government should have an integrated approach for convergence of various programmes such as Comprehensive Health Insurance Scheme (CHIS), CHIS PLUS, Arogya Kiranam, Karunya Benevolent Fund, Thalolam and Cancer Protection Scheme. Each scheme is now having a different benefit package and different guidelines for implementation which hampers effective service delivery. Noting that the expenditure on medicines and laboratory tests are a drain on the common man’s finances, the committee said that the strategy should aim at providing these services at all three levels of service delivery. The Karunya Community Pharmacy model should be extended to all secondary and tertiary facilities. Along with the distribution of free generic drugs, the government should also think of providing free investigation, the report said.
With respect to prevention of Non-Communicable Diseases, the committee notes that improving the services in the public sector would help in bringing down the prevalence of the NCDs. The screening for NCDs at the primary care institutions should be strengthened and also medicines for NCDs should be made available free of cost at all levels of public health facilities especially at primary health institutions. Laboratory facilities in PHCs and CHCs should also be ensured, the report said.