Severe fragmentation responsible for poor performance of Indian healthcare: Yaduvendra Mathur, Special Secretary, NITI Aayog

Jaipur: Low performance of Indian healthcare compared to similar countries in Asia is due to a vicious cycle of severe fragmentation. The time has come to unify and transform the healthcare system to achieve optimum outcomes in terms of public health and Sustainable Development Goals. This was said by Sh. Yaduvendra Mathur, IAS, Special Secretary, NITI Aayog, at the inaugural session of Pradanya 2019, IIHMR University’s annual international conference, as the Chief Guest and Keynote Speaker.

The 24th edition of the annual event is being organized by the University on the theme of “Future of Healthcare: Globalization, Innovations and You.” More than 35 health experts from India and abroad are attending the technical sessions and panel discussions spread across three days.

Sh. Yaduvendra Mathur noted that India’s healthcare system lags much behind other nations. India figures at number 145 in global healthcare, compared to 92 for China, 71 for Sri Lanka, 138 for Indonesia and 111 for Egypt. The Out of Pocket (OOP) expenditure for India is high at 63%, compared to just 36% for China and 37% for Indonesia. He added: “Such sub-par performance of Indian healthcare is due to its deeply fragmented nature. This fragmentation needs to be addressed through better risk profiling / insurance of patients, strategic purchasing of medicines and medical supplies by government and care givers, better organization of healthcare delivery, and creating a digital health landscape. Ayushman Bharat and initiatives like National Medical Commission Act and National Digital Health Blueprint have created a strong foundation for such integration.”

Sh. Yaduvendra Mathur said that the future health system of India needs five focus areas: Deliver on the unfinished public health agenda; shift health financing away from out-of-pocket spend to larger insurers; integrate service delivery horizontally and vertically; empower citizens to become better buyers of health; and harness the power of digital health. He further said that the financing landscape, service delivery, health records and purchase of medical supplies are severely fragmented.

Sh. Yaduvendra Mathur said: “The financing landscape for health is extremely fragmented. While 63% of the total health expenditure comes from out-of-pocket, the rest is accounted for by over a dozen schemes like PMJAY, state health pool, central health schemes, NHM, ESIS, etc. To address this, PMJAY should be strengthened and all national and state government pools should be merged into it on output basis. Key purchasers like ESI and commercial purchasers should be strengthened, and a robust common regulatory framework should be created for all contributory insurers.”

Sh. Yaduvendra said that a systems approach to healthcare can revolutionize Indian healthcare by delivering immense benefits. “By 2030, more than a million additional infant deaths can be prevented and there can be reduction in OOP expenses to 45%, saving at least 1.5 million additional households from poverty. Adult deaths can be reduced by up to 16% and the country’s economic growth can be increased by up to 30% over the current trajectory. India would also emerge as the leading health service exporter to the world,” he added.

Dr Sujata Saunik, IAS, Additional Chief Secretary, Dept. of Skill Development & Entrepreneurship, Govt. of Maharashtra was the Guest of Honour at Pradanya 2019. She recounted five things that would impact Indian healthcare in a big way. She said: “First is innovation – we have to create new ways to manage public health at district, state and national level. Second is climate change which is going to majorly impact our agriculture, our diet, and disease profiles. Third is malnutrition – the average child in India suffers from significant wastage and stunting. Fourth is the rising burden of chronic diseases that need life-long care. Fifth is the absence of electronic health records in the country, due to which we cannot still exploit technological tools like machine learning and artificial intelligence to solve the challenges of public health.”

Dr. Pankaj Gupta, President, IIHMR University, Jaipur, said that IIHMR University has research-oriented professors with immense industrial experience. “This wonderful concept of our University enriches learning, nurtures and guides the students to blossom into future leaders of tomorrow,” he added.

Addressing the audience, Dr SD Gupta, Chairman, IIHMR University, Jaipur, said: “Future healthcare is intrinsically linked with globalization and technological innovations. We need to visualize what the scenario is going to be in India in the next 30 to 40 years. The number of elderly population will rise substantially. Life expectancy would touch 80 years. Climate change will impact public health in a big way. Non-communicable diseases will form the bulk of national disease burden. India’s healthcare system needs to be reoriented towards meeting these challenges. Incremental changes will not be enough – we need total restructuring. New models are needed by learning from other countries.”

Captivating sessions attended by experts in healthcare, pharma industry, and public health were held daylong on topics such as using technology to enhance healthcare, value-based healthcare, tackling price transparency, and new directions in preventive healthcare.

Pradanya 2019 will conclude on November 25, 2019.