Universal Health Coverage

Subject :International Relations

Section: Nuclear technology

Concept :

The right to health is one of the fundamental rights of every human being. India’s constitution guarantees the right to life, which includes the right to health, as a basic human right.
The World Health Organization (WHO) has defined health as a certain totality of health to the realms of mental and social well-being and happiness beyond physical fitness, and an absence of disease and disability.
However, achieving health in its wider definition requires addressing health determinants, which necessitates intersectoral convergence beyond medical and health departments.

The Alma Ata Declaration of Primary Health Care:

In 1978, the International Conference on Primary Health Care was held in Alma Ata, Kazakhstan.
The Alma Ata declaration of primary health care, which mandated basic health care for all citizens, was not implemented in its entirety, resulting in partial coverage of the population and partial responsibility of the government to pay for health care.
It mandated all health promotion activities, and the prevention of diseases including vaccinations and treatment of minor illnesses and accidents to be free for all using government resources, especially for the poor.

Newer concept of UHC:

The focus on primary care, as mandated by the Alma Ata declaration of primary health care, must be revived to ensure that healthcare services are accessible, affordable, and of good quality for all citizens.
A tax-funded model of Universal Health Care would ensure that healthcare services are available to all citizens without discrimination.
It would also ensure that the burden of healthcare financing is shared by the government and the citizens, with the government taking the responsibility for providing healthcare services to all citizens.
Such a model would also prioritise primary healthcare services, which are essential for promoting good health and preventing diseases.
Additionally, a tax-funded model would ensure transparency and accountability in healthcare delivery.
Government should also focus on intersectoral convergence beyond medical and health departments, such as women and child development, food and nutrition, agriculture and animal husbandry, civil supplies, rural water supply and sanitation, social welfare, tribal welfare, education, and forestry, to address health determinants.

India and UHC

India, through its National Health Policy 1983, committed itself to the ‘Health for All’ goal by 2000.
The National Rural Health Mission (NRHM) in India, which operationalized a Comprehensive Primary Health Care model, is a sensible move towards achieving UHC.
The National Health Mission with concurrent intersectoral thrusts on Poshan Abhiyan, National Food Security, the Mahatma Gandhi National Rural Employment Guarantee Act, water sanitation, Sarva Shiksha Abhiyan, etc. is a better model of fully taxfunded Universal Health Care, but the Ayushman Bharat Jan Arogya Bhima Yojana damages (AB-JAY) that approach.

Limitations of AB-JAY:

While the intentions of the Ayushman Bharat Jan Arogya Bima Yojana (AB-JAY) are noble, it has received criticism from various quarters.
One of the primary concerns is that it is an insurance-based model and not a tax-funded model, which means that the financial burden of the scheme falls on the government and the beneficiaries.
The scheme provides insurance cover to only those who have been identified as being below the poverty line, which means that a large section of the population is excluded from the scheme.
Additionally, the scheme has been criticised for its narrow focus on secondary and tertiary care, which ignores the importance of primary care in promoting good health.