Game changer — Healthcare reform | Himanshu Baid

The announcement of the Ayushman Bharat- National Health Protection Mission (AB-NHPM) for the vulnerable section of the Indian population, often quoted as tectonic shift in the healthcare ecosystem of India, is poised to bring abundance of opportunities for indigenous healthcare manufacturers and generate sizeable amount of employment. The scheme will have multiplier impact on healthcare and allied sectors. However, the execution of scheme and sustainable development will be a tall task for the Government of India.

The scheme is innovative and path-breaking, it will help India’s economy, healthcare, and social landscapes to evolve. The standard treatment guidelines and defined packages rates for the hospital will increase the need of affordable and global standard quality solutions. Apparently it will usher domestic manufacturers products to become the preferred choice over high cost imported products. However, to foster innovation among manufacturers to address the evolving needs of hospitals and caregivers, arbitrary price control mechanisms should not be applied to MedTech products as they become hindrance to innovation and promotion of new technology.

The AB-NHPM scheme is expected to take India towards universal health coverage and it has far-reaching impact on the entire healthcare ecosystem and economy. In the current healthcare

financing, more than 2/3rd of expenditure on healthcare is out of pocket, the scheme will significantly bring down the out of pocket healthcare expense and have an indirect impact on individual wealth which will lead to economic growth of the nation. The other longer term and most important impact of the scheme will be the data repository through AB-NHPM, it will facilitate research and evidence-based decision making in future.

The emergence of the scheme will steer the increase in medical devices consumption, as the larger percentage of population will be able to afford secondary and tertiary care which will eventually lead to higher hospital occupancy specially in tier II and tier III cities. This technology-driven initiative also encourages increased investment in healthcare and generates
employment, in abundance.

The scheme has its own shortfalls, the overburdened public hospitals, availability of hospital beds and lack enough doctors in the country is abysmal. In India, we have 0.8 physician per thousand people, one of the lowest ratio in the world. India is at least 75 per cent short of the number of qualified doctors it needs. Thus, even if people are covered under Ayushman Bharat, the quality of healthcare they will have access to remains under a question mark. A recent PwC-CII study lists the needs for a proper monitoring structure, challenges in empanelling hospitals, identifying beneficiary and potential for fraud as risks.

The future after the scheme launch looks progressive and equally challenging for GoI, state governments and the medical device industry could work together on effective procurement and distribution models, to meet healthcare goals and help address the challenges of healthcare access in India. Providing insurance covers alone will not improve the health system in the country. Rather, there is a need to build robust healthcare infrastructure in the remotest corners of the country where people have easy access. Budget allocation needs to be increased to realise the purpose of the scheme and hit the ambitious goal of becoming provider to payer and achieve universal health coverage in the true sense.

Next article: AB will create a far reaching impact | Sunil Khurana