Focusing on Primary Health to Achieve Universal Health Coverage in India

Healthcare financing is one of the critical determinants of achieving better health outcomes. In India, central and state funding collectively represents about twenty percent of total health spending. ACCESS Health conducted an exhaustive analysis and comparison of the benefit packages of government sponsored programs in India. To read the full report, click here.

The current design of government supported healthcare financing currently puts a heavy emphasis on hospital and specialty care, neglecting primary healthcare coverage as an integral part of the health system. This oversight creates a real challenge in extending universal health coverage in India. Based on our analysis, we believe that the health system must be redesigned to place more emphasis on primary healthcare services, making it a backbone to the system as a whole.

Ambulatory care constitutes a much higher share of overall health expenditure than inpatient care. In addition, cost of the ambulatory services are usually borne out of pocket. Primary healthcare screening, accompanied by ambulatory services that serve as gatekeepers to patient health, could curtail unnecessary hospitalization and reduce the financial burden of costly tertiary and specialty services.

In the attempt to extend universal health coverage, we also propose that the existing health insurance programs be designed to include all populations, both above and below the poverty line. For example, those living above the poverty line could contribute to the cost of health insurance premiums, thereby lifting some of the burden on limited funding sources. For a full analysis click here.