Towards Universal Health Coverage? Two decades of health reforms in India

A survey of reforms in health policies in India over the past two decades – actually a string of privatisation policies – indicates that we have moved away from and not towards Universal Health Coverage. What then needs to be done? T K Sundari Ravindran, Neena Elezebeth Philips take stock of two decades of health reforms in India


The Covid-19 pandemic has cast the spotlight on India's public health system and its many weaknesses. The public health system has been stretched beyond its limited resources, struggling to carry out the complex tasks of preventing, testing, and treating millions. The media is replete with heart-rending stories of persons being denied services not only in the overstretched government hospitals but also in well-resourced private hospitals. India’s claims of pursuing Universal Health Coverage (UHC) that would guarantee quality health care by public and private hospitals to the poorest households through an ambitious set of reforms, including Ayushman Bharat, ring hollow.

1. Introduction: Over the past two decades, India has implemented a wide range of reforms in the health sector. Drawing on existing evidence, this essay argues that these changes have made a limited contribution to making healthcare available and affordable for socially and economically marginalised groups. It concludes by listing the much-needed steps that do need to be taken for India to move anywhere close to UHC.

Where does India stand in terms of achieving UHC? There are three dimensions to UHC: population coverage, services coverage, and financial risk protection. The goal is to make available to 100% of the population a broad-enough range of essential health services that cover 100% of their healthcare needs, and ensure that 100% of the population can receive these services without incurring health expenditure that is more than 10% of the monthly household expenditure....




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