The Centre has tasked an expert group to frame a road map for the Universal Health Assurance Mission (UHAM), an ambitious programme to provide free universal health insurance to those below the poverty line. It will provide 50 essential drugs in generic form, a package of diagnostic services, and about 30 Ayush (ayurveda, naturopathy, unani, siddha and homoeopathy) drugs to all citizens at government hospitals and health centres. The premium for health insurance will be kept low for those who can pay. If the government can carry the states along, this has the potential to revolutionise the manner in which millions of people access healthcare in India. As of now, only 25 per cent of the country has insurance coverage. The rest are unprotected and vulnerable to the extent that even one major road accident or a bout of serious illness can wipe out the savings of an entire family. Such a mission needed to be implemented long ago.
However, for the scheme to be truly effective, India’s overall healthcare infrastructure has to be overhauled. Universal insurance must shift at least some of the patient burden on the private sector. The government must ensure the private sector is properly regulated so that patients aren’t scammed or trapped by their insurance providers. One of the biggest challenges would be to keep up the supply of doctors and technical personnel. The present doctor to population ratio, one to 1,700, needs to be improved. A great number of technical personnel in diagnostics and radiology among others is also necessary.
Health is a state subject and the state’s ownership and thrust on governance determines its success. This is the lesson from the National Rural Health Mission. It is therefore vital that the state governments are on board at heart and not superficially if the mission is to succeed. All the good intentions of the mission would be of no avail if there is dissonance between the Centre and state governments. There is a great deal of promise in the scheme. One hopes the lofty mission would find sincere implementation.