Healthcare activists balk at 12th Five year Plan document's proposals

The Jan Swasthya Abhiyan, or people's health movement network, has voiced concern over the 12th Five Year Plan document's proposal for restructuring the country's health system, saying it would "effectively hand over health care to the corporate sector"."It is particularly problematic that the Plan document to be adopted by the panel by the end of this month, invokes the concept of Universal Health Care, while it actually proposes a strategy that is far removed from the basic tenets of universal health care,'' Jan Swasthya Abhiyan, a conglomerate of rights-based health activists said here on Wednesday.

Srinath Reddy, chairman of the now disbanded High Level Expert Group (HLEG), set up by the Planning Commission to draw a blueprint for universal health coverage and has convened a meeting of the HLEG on Thursday.

The Jan Swasthya Abhiyan activists claim that instead of the proposed 2.5% of total GDP that the government had intended to spend on healthcare only 1.58% will be spent. The current spending is approximately 1%. This is woefully inadequate considering the United States spends a staggering 17.4 % of its GDP on healthcare (Source: Organisation of Economic Development 2009).

Another bone of contention is the suggestion that centre would be spend less than half of what each of the states spends on healthcare.

"What is of greater concern is the strategy proposed for re-structuring of the country's health system in the document that proposes a transition from the present system which is a mix of public sector service provision plus insurance, to a system of healthcare delivered by a managed network. There, is thus, a road map envisaged where the government would abandon its central role of providing health care and become primarily just a manager of the new system,'' Amit Sengupta of Jan Swasthya Abhiyan said.

He feels that the document would be both funding and providing preventive interventions (vaccination, neo-natal care and other non-profit services) at different levels but the clinical services would be financially supported by the government and not universally provided. This would play into the corporate sector's hands who are already dominating the medical scene (India already has one of the highest out-of-pocket expenditures in the world).

"This would mean that the government would over time confine itself to providing a small package services and would be primarily just a purchaser of virtually all clinical services from the corporatized private sector. The government would, thus, finance (with public money), strengthen and bolster an already resurgent corporate sector providing medical services,'' Jashodhara Dasgupta of Sahyog and member of HLEG said adding that it would also decisively halt and eventually reverse the moderate achievements of the National Rural Health Mission in expanding public health infrastructure and services.

Reacting to the draft Plan documents, Dr Reddy told a leading daily that the public sector would remain the primary provider of healthcare and the private sector would be contracted only to supplement the services through a well-defined regulatory process.

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