Edition 19 | March 22, 2023

Dear Friends,


We are delighted to present to you the next edition of the monthly newsletter by the Lancet Citizens' Commission on Reimagining India’s Health System. This edition discusses the estimated funds required for Universal Health Coverage (UHC) within Indian states, explores pathways to reimagining commercial health insurance in India, an analysis of how to protect families from ruinous healthcare costs and more. 

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This Month's Highlight

Estimating funds required for UHC within Indian States


Bihar, with a GHE of 556 per capita (per annum), has the lowest state government spending, but there are many states in which governments spend more than four times that amount on a per capita basis. However, despite this, no state offers UHC to its residents. This failure to provide UHC could be because even the highest amounts spent by the state governments are too low for them to offer UHC or because the cost differences between states are very high, write Nachiket Mor and Sudheer Kumar Shukla.

News from the Commission

Solving endgame problems for 1·4 billion people in India


Previously, India's approach to health policy making and planning has focused on solving seemingly immediate or urgent societal problems with solutions that could be implemented by avoiding multisectoral involvement from other sectors. This approach has resulted in short-term investments and missing the global health and developmental targets. India needs to begin focusing on solving its endgame problems, write Siddhesh Zadey and Sweta Dubey.

Pathways to reimagining commercial health insurance in India


In this paper, we explore how India's growing commercial health insurance (CHI) segment can be reformed to deliver adequate financial protection and good health outcomes. We lay out key issues in the demand- and supply-sides of the insurance market that need to be addressed for CHI to be more aligned toward universal health coverage (UHC), write Hasna Ashraf, Indradeep Ghosh, Nishanth Kumar, Anjali Nambiar  and Sowmini Prasad.

Views & Opinions 

Protecting families from ruinous healthcare costs


With the very limited government money on offer and the need for protection being almost universal, the States would do well to use that money instead to offer an insurance plan that covers their entire population (the poor and the non-poor) for only a limited number of very expensive and very rare conditions. Knowing that they have this coverage will give all their people peace of mind and stability, even though most will never use it, writes Nachiket Mor.

How data can empower MPs to serve people better


A new interactive PC data tracker developed by the Geographic Insights Lab at Harvard University has for the first time provided data on crucial population, health, and well-being estimates for each of the 543 PCs, and including a factsheet for each PC, writes S.V. Subramanian.

A pandemic-ready world



The exercise to strengthen WHO’s International Health Regulations Framework must balance sovereignty of member-nations with facilitation of timely action, writes Prof K Srinath Reddy.

Resource

Progress on Sustainable Development Goal indicators in 707 districts of India: a quantitative mid-line assessment using the National Family Health Surveys, 2016 and 2021


India has committed itself to accomplishing the Sustainable Development Goals (SDGs) by 2030. Meeting these goals would require prioritizing and targeting specific areas within India. We provide a mid-line assessment of the progress across 707 districts of India for 33 SDG indicators related to health and social determinants of health, write S.V. Subramanian, Mayanka Ambade, Akhil Kumar, Hyejun Chi, William Joe, Sunil Rajpal and Rockli Kim.

Commission Member in Spotlight 

"Government expenditure on health is one of the lowest in the world and the lowest among all the G-20 countries. This results in majority of healthcare being provided by the private sector and high out-of-pocket expenditure on health. Health financing in the country, largely based on out-of-pocket expenditure, is neither efficient nor equitable. This not only discourages timely and appropriate treatment, it also penalises the weaker and most vulnerable segment of population the most. A greater proportion of budget needs to be allocated to primary health care, health research and non-communicable health programmes," says Indu Bhushan, Chairperson, Partnership for Impact (P4i) and former CEO of National Health Authority

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Featured Partner

SEWA is a National Trade union registered in 1972 with a membership base of over 1.5 million (2018) poor, self-employed women workers from the informal economy across 16 states in India. SEWA is providing research support to the Citizens' Engagement and Governance workstreams of the Commission.

Help us develop a roadmap to achieve universal health coverage in India by visiting our website: https://www.citizenshealth.in/


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We love hearing back from you! Please send your comments, suggestions, and contributions for these newsletters, including research highlights and published features to citizenhealthin@gmail.com

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