The coronavirus outbreak, reported first at the end of 2019, was declared a global pandemic in October 2020 by the World Health Organization. Countries tackled the outbreak in different ways, but some healthcare systems crumbled under the crisis, highlighting the immediate need for innovative strategies to strengthen public healthcare.
This urgent need led India to adopt proactive measures such as imposing complete mandatory lockdowns, and declaring masks and sanitisers to be essential commodities. The Indian Constitution treats health as an important aspect of human life. Article 21, which guarantees the fundamental right to life to all citizens may well include access to basic healthcare. However, the pandemic has made the government realize that a large percentage of the population has no access to such healthcare.
Examination of the healthcare systems of some developed nations may show the changes needed in India for it to be better equipped. It should be accepted, however, that the pandemic has put an immense strain on even the best healthcare systems.
The Italian national health service aims to provide either free or subsidized healthcare services. The Italian constitution requires the government to provide all indigent residents with access to free medical care. The government has achieved this through the collection of a corporate tax or a regional tax on productive activities. The government also levies a personal income tax, which is used to finance the public health systems of regions that lack resources. The aspects of healthcare services that are covered will depend on medical necessity, effectiveness, human dignity, appropriateness and efficiency in delivery.
The Swedish public healthcare is largely funded by the government. The aim of the government is to ensure that everyone has equal access to healthcare services. A feature of the healthcare service in Sweden is that it is decentralized. The onus is on 21 regional councils, consisting of representatives elected every four years, to ensure accessibility. The Swedish Health and Medical Services Act 1982 requires the councils to promote the health of their residents and to ensure equal access to healthcare. In this way the government ensures that quality healthcare is available to everyone through large-scale spending on health, medical and social care.
Germany has a healthcare system going back many years. It is a dual public-private and multi-payer system. The system features statutory health insurance for all residents with an annual income below a specified threshold, and private insurance for those who have an annual income above that level and who choose to purchase their own. Employees pay a certain percentage of their salary as premiums into the public health insurance pool and employers match such contributions. The healthcare system in Germany is so accessible and efficient because it has one of the largest expenditures on healthcare in the world in terms of GDP.
India, as the second most populous country in the world has a healthcare system overburdened by an ever-increasing population. A large percentage of the population lives in rural areas and has limited access to quality healthcare. The healthcare system does not provide quality healthcare and faces steadily rising costs. These are the results of the dilapidated state of the healthcare system caused by the failure of policies and laws to provide the funding for a better healthcare infrastructure.
An efficient system of regulation is necessary to rectify the issues facing the healthcare system. Although codes, acts and rules governing healthcare services exist, there is a widespread failure to enforce them. This is again due to the lack of expenditure on public health. India spends less than 2 percent of its GDP on public health. Therefore, existing policies must evolve to ensure not only that every citizen has access to healthcare, but also that the country has an adequate infrastructure to make this possible. The focus of the public health system should shift so that it is based on fundamental principles of equality. Furthermore, there must be consultations and partnerships between policy makers, medical professionals, industry players and academicians to find solutions to the challenges faced by the healthcare system.
Rhea Sydney is an associate at J Sagar Associates
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