Roadmap for Answer Writing

1. Introduction

• Define the importance of public healthcare as a fundamental right and the role of the state in ensuring access to it.
• Briefly mention the adverse impacts of the marketisation of healthcare.

2. Adverse Impact of Marketisation

• High Costs: Explain how a market-driven system increases treatment costs and affects affordability.
  • Fact: Out-of-pocket expenditure on healthcare in India accounts for approximately 62% of total health expenditure (World Bank, 2019).
• Inequality in Access: Discuss the concentration of healthcare facilities in urban areas and its effect on rural access.
  • Fact: Over 80% of doctors and 60% of hospitals are located in urban regions, leaving rural areas underserved (Bharat Health Index, 2023).
• Resource Allocation: Describe the uneven distribution of healthcare resources due to profit-driven motives.
  • Fact: Rural healthcare often lacks basic infrastructure due to resource allocation favoring urban centers.
• Regulatory Challenges: Highlight issues related to weak regulations in private healthcare.
  • Fact: Reports indicate frequent overcharging and substandard care in private facilities due to inadequate regulation.

3. Role of the State in Enhancing Public Healthcare

• Primary Healthcare Reinforcement: Emphasize the need for stronger infrastructure in Primary Healthcare Centers (PHCs).
  • Fact: The Bhore Committee recommended strengthening primary healthcare for better access.
• Public-Private Partnerships: Discuss the potential of collaborations to improve healthcare access.
  • Fact: The Rajiv Aarogyasri Scheme in Andhra Pradesh enhances access to specialized care for economically weaker sections.
• Integrating Telemedicine Services: Explain how telemedicine can bridge gaps between urban and rural healthcare.
  • Fact: The National Telemedicine Taskforce has significantly expanded telemedicine services across rural India.
• Ongoing Training for Healthcare Workers: Stress the importance of regular training for healthcare personnel.
  • Fact: The National Rural Health Mission conducts ongoing training programs for rural health workers.
• Empowering Community Health Workers: Highlight the role of ASHAs and similar workers in grassroots healthcare delivery.
  • Fact: ASHAs were crucial in COVID-19 awareness and screenings in rural areas.
• Enhanced Public Health Financing: Discuss the need for increased government spending on healthcare.
  • Fact: The National Health Policy 2017 recommends increasing healthcare spending to 5% of GDP.

4. Measures to Enhance Reach at the Grassroots Level

• Implementing Treatment Cost Caps: Suggest setting maximum prices for essential services.
  • Fact: Cost caps can prevent overcharging in treatments like cardiovascular surgeries.
• Availability of Subsidised Medications: Advocate for affordable medicines through initiatives like Jan Aushadhi stores.
  • Fact: Jan Aushadhi stores provide essential drugs at reduced prices.
• Quality Assurance in Private Healthcare: Recommend enforcing strict quality standards in private facilities.
  • Fact: Regular audits of private hospitals can ensure compliance with ethical practices.
• Health Literacy Campaigns: Highlight the need for public awareness about government healthcare programs.
  • Fact: Campaigns like ‘Jago Grahak Jago’ effectively raise awareness about consumer rights.
• Increasing Generic Drug Supply: Promote the availability of generic medicines to reduce costs.
  • Fact: Access to generic drugs can significantly lower healthcare expenses for the population.

5. Conclusion

• Summarize the critical role of the Indian State in countering the adverse effects of marketisation in healthcare.
• Emphasize the importance of implementing these measures to ensure universal and equitable access to public healthcare.

Relevant Facts and Sources

1. World Bank (2019): Out-of-pocket expenditure accounts for approximately 62% of total health expenditure in India.
2. Bharat Health Index (2023): Over 80% of doctors and 60% of hospitals are concentrated in urban areas.
3. Bhore Committee Recommendations: Advocated for strengthening primary healthcare systems.
4. Rajiv Aarogyasri Scheme: Example of effective public-private partnership in healthcare.
5. National Telemedicine Taskforce: Expanded telemedicine services across rural India.
6. National Rural Health Mission: Conducts ongoing training for rural healthcare workers.
7. National Health Policy 2017: Recommends increasing healthcare spending to 5% of GDP.

This roadmap will assist in structuring a comprehensive answer that addresses the role of the Indian State in enhancing public healthcare access and counters the negative impacts of marketisation.