Health sector governance and resource generation

There is recognition of the need to increase stewardship and oversight of healthcare and pension programmes, improve coordination across different implementing agencies, and ensure that social protection programmes remain robust and sustainable, said Prof Mukul Asher, Professorial Fellow, Lee Kuan School of Public Policy in his address. Sharing his insights on health sector governance and resource generation, Prof Asher also highlighted how essential it is to have an effective framework for good governance and efficient management of resources.

Accentuating the importance of organisations in delivering healthcare and pension services, he advised that it was essential to ensure professionalism, training, and capacity of organisations and institutions as these would have significant impact on the outcomes of these programmes.

He also elaborated on the various governance failures such as information asymmetry, moral hazard, adverse selection, etc across publicly financed and privately organised financed programmes. He was of the opinion that these failures can be overcome only with the aid of a range of policy tools, thereby making a strong case for active oversight and regulation of health programmes. Creating a system of counterweighing incentives and disincentives to shape their economic behaviour and recasting the generic model of health system were some of his other recommendations.

Moving on, Prof Asher gave on overview of the existing healthcare system in India and the delivery and financing models which are currently in practice. He also emphasised on the developing the right funding-financing mix as per the country’s needs and opined that public healthcare programmes must be designed not to pay for all healthcare expenditure but cover catastrophic expenditure, and some form of cost-sharing for minor episodes of illnesses. He pointed out that there is no society which can provide best health services all the time, hence management of existing resources is key.

Key recommendations

• Governments need to reconcile conflicting goals of stakeholders through a concerted use of policy tools
• Any social protection system should provide benefits with credibility and confidence to all stakeholders in society
• Each health system should develop its own financing mix based on a combination of instruments like commercial insurance, social insurance, tax financed programmes etc.