Presented by:

Gurjit kaur
M.SC.(N)2ND yr.

HEALTH CARE REFORMS:

Health care reform is a
general rubric used for
discussing major health
policy creation or
changesfor the most
part, governmental policy
that affects health care
delivery in a given place.

OBJECTIVES
Expand the array of health care providers
Improve the access to health care specialists
Improve the quality of health care
Give more care to citizens

contd:
Broaden the population that
receives health care coverage
through either public sector
insurance programs or private
sector insurance companies

Decrease the cost of health care

TOP REASONS TO SUPPORT HEALTH

CARE REFORM:
Ends Discrimination
For Pre-existing
Conditions

Ends Cost-Sharing for

Preventive Care

Ends Exorbitant Out-ofPocket Expenses

Ends Dropping of
Coverage
for Seriously Ill

Ends Gender
Discrimination.

Extends Coverage for

Young Adults

Ends Annual or Lifetime

Caps on Coverage

Guarantees
Insurance Renewal

HEALTH CARE
REFORMS IN INDIA

COMPREHENSIVE CARE
- Bhore committee 1946
Provide adequate preventive, curative and
promotive health services.
Be as close to the beneficiaries as possible.
Widest cooperation between the people,
the service and the profession.

contd:
Is available to all irrespective of their
ability to pay
Look after specifically the vulnerable and
weaker sections of the community
Create and maintain healthy environment
both in home as well as working places

BASIC HEALTH SERVICES

A basic health service is understood to be a
network of coordinated, peripheral and
intermediate health units capable of
performing effectively a selected group of
functions essential to the health of an area
and assuring the availability of competent
personnel and auxiliary personnel to
perform these functions

PRIMARY HEALTH CARE

The Alma-Ata international conference
gave primary health care a wider meaning
Primary health care is essential health care
made universally accessible to individuals
and acceptable to them , through their full
participation and at a cost the community
and country can afford

PRINCIPLES OF PRIMARY
HEALTH CARE
Equitable distribution

Community participation
Inter sectoral coordination
Appropriate technology

ISSUES IN HEALTH CARE

REFORMS
UNEQUAL
DISTRIBUTION OF
HEALTH CARE
RESOURSES

PRIVATE HEALTH
CARE AND
ECONOMIC
INEQUALITY

ISSUES IN HEALTH CARE

REFORMS
1.

UNEQUAL DISTRIBUTION OF
HEALTH CARE RESOURSES
The ratio of hospital beds to population in
rural areas is fifteen times lower than that
for urban areas
The ratio of doctors to population in rural
areas is almost six times lower than that in
the urban population

CONTD:
Per capita expenditure on public health is
seven times lower in rural areas, compared
to government health spending for urban
areas
The most peripheral and most vital unit of
Indias public health infrastructure is a
primary health centre (PHC)

 In a recent survey it was noticed that only

38% of all PHCs have all the essential
manpower and only 31% have all the
essential supplies (defined as 60% of
critical inputs), with only 3% of PHCs
having 80% of all critical inputs.

 Though the spending on healthcare is 6%

of gross domestic product (GDP), the state
expenditure is only 0.9% of the total
spending. People using their own resources
spend rest of it. This makes the Indian
public health system grossly inadequate
and under-funded.

 Only five other countries in the world are

worse off than India regarding public
health spending (Burundi, Myanmar,
Pakistan, Sudan, Cambodia). As a result of
this dismal and unequal spending on public
health, the infrastructure of health system
itself is becoming ineffective.

ACCESS DIFFICULTIES TO
HEALTH CARE
Geographical
distance
Socio-economic
distance
Gender distance

ISSUES IN HEALTH CARE REFORMS

2.

PRIVATE HEALTH CARE AND

ECONOMIC INEQUALITY
The growth of private healthcare sector has
been largely seen as a boon, however it
adds to ever-increasing social dichotomy.
The dominance of the private sector not
only denies access to poorer sections of
society, but also skews the balance towards
urban-biased, tertiary level health services
with profitability overriding equality, and
rationality of care often taking a back seat.

CONT
The increasing cost of healthcare that is
paid by out of pocket payments is making
healthcare unaffordable for a growing
number of people. The number of people
who could not seek medical care because
of lack of money has increased
significantly between 1986 and 1995

CONT
The proportion of people unable to afford
basic healthcare has doubled in last decade.
One in three people who need
hospitalization and are paying out of
pocket are forced to borrow money or sell
assets to cover expenses.
Over 20 million Indians are pushed below
the poverty line every year because of the
effect of out of pocket spending on health
care.

CONT..
In the absence of an effective regulatory
authority over the private healthcare sector
the quality of medical care is constantly
deteriorating.

PROS OF HEALTHCARE
REFORMS

Becoming
more
efficient

New model
of care

Helps the
bottom line

CONS
Administrative
costs
Cut in
payments

Coverage

SUMMERIZATION