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HOPS AS A ROUTE TO UHC
What the article is about?
- Talks about the HOPS model and its possibility to realise UHC
Syllabus: GS-III Public health
Public Health Care:
- Universal Health Care (UHC) has become a well-accepted objective of public policy around the world.
- It has even been largely realised in many countries- Brazil, China, Sri Lanka and Thailand.
- Thailand, made a decisive move toward UHC 20 years ago when its per capita GDP was no higher than India’s per capita GDP today.
- It has even been largely realised in many countries- Brazil, China, Sri Lanka and Thailand.
- The basic idea of UHC is that no one should be deprived of quality health care for the lack of ability to pay.
- In concrete terms, UHC typically relies on one or both of two basic approaches: public service and social insurance.
- 1st approach: health care is provided as a free public service, just like the services of a fire brigade or public library.
- 2nd approach: allows private as well as public provision of health care, but the costs are mostly borne by the social insurance fund(s)
- Insurance is compulsory and universal, financed mainly from general taxation, and run by a single non-profit agency in the public interest- the Canada model.
- Challenges:
- In a system based on social insurance, public service plays an essential role.
- There is a danger of patients rushing to expensive hospitals every other day. This would make the system wasteful and expensive.
- One possible remedy is to require the patient to bear part of the costs (a “co-payment”, in insurance jargon), but that conflicts with the principle of UHC.
- Another challenge with social insurance is to regulate private healthcare providers.
- In a system based on social insurance, public service plays an essential role.
- Most countries with UHC rely on a combination of public service and social insurance
- However, the National Health Service (NHS) model in Britain based on plain public service may be the best approach.
- Private non-profit health care can be regarded as a form of public service, and private for-profit health care tends to defy discipline.
Possible route for India to UHC:
- Envisage a framework for UHC that would build primarily on health care as a public service, and have a chance at least to converge toward some sort of NHS in due course.
- This framework might be called “healthcare as an optional public service” (HOPS).
- Everyone would have a legal right to receive free, quality health care in a public institution if they wish.
- It would not prevent anyone from seeking health care from the private sector at their own expense.
- But the public sector would guarantee decent health services to everyone as a matter of right, free of cost.
- Tamil Nadu is well placed to make HOPS a reality under its proposed Right to Health Bill.
