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Latest information on social security and health in India
OF PRIMARY CARE IN THE CONTEXT OF UNIVERSALISATION OF
HEALTH CARE BY GOVT OF INDIA/ODISHA.
With only 30% of India’s Population is having health care insurance, universalisation for the entire population was a dream till Govt. of India recently announced “Ayushman Bharat”. Similarly Odisha Govt. has announced “Biju Health & Welfare Scheme”(Biju Swasthya Kalyan Yojana) for covering entire population of Odisha for providing Health Care Facilities particularly Secondary & Tertiary Care. In this debate or tussle between Central Govt. & the State Govt., this article attempts to define the key role of
primary care to achieve universalisation of Health Coverage in India.
It is necessary to emphasis as to why such primary care oriented system is emerging as important health care institution in this globalized world due to following reasons:-
(1) Medical science definitely believes that tertiary care procedure would be prevented by timely primary care facility to patients.
(2) Almost 80% of our patients/beneficiaries in a social security concept visit such family doctor in the form of dispensary or medical practitioner or primary health care Centre whatever you may call. This is also a fact almost 80% of our routine problems are effectively treated or managed by so called
general practitioners or family physicians.
(3) Another important reason for increasing emphasis on primary health care is due to the fact that it integrates preventive, promotive, curative and rehabilitative aspect of health care. This may popularly be called ‘All in One’ concept which is particularly to be seen in the context of our country where
76% of the population lives in rural area shaving access to 26% of doctors’ population.
(4)Due to rising cost of medical care, emphasis is now on primary health care because health care indicators such as maternal mortality, infant mortality and Life expectancy are better in European countries because of strong primary care setup unlike the U.S. where focus is more on tertiary care.
(5)In a run up to high ended treatment entailing costly expenditure, it is primary health care detection which will not only reduce demand on limited resources available for tertiary care treatment but will also definitely ensure affordable medical care with little improvisation and support in the form of
availability of a Physician and Pediatrician in a small place of 600 to 1000 Sq.ft having nursing and diagnostic services. Such primary care clinic is not only cost effective both from infrastructure and human resources point of view but also satisfaction level as far as general public is concerned.
(6) In absence of primary health care facilities, workers/citizens tend to rush to hospitals-adversely affecting out of pocket expenses, thereby driven to loans/poverty level in our country. In view of recent decisions of Central Government toward increased FDI in Insurance Industry & Opening
of Private Health care Provided by Insurance agencies for beneficiaries of Government controlled Social Security Schemes like ESI, there is now a great Opportunity to secure “Universal Health care & Minimum Cash Benefits” in the form of Pension & Accidental Deaths etc. for Workers in particular & citizens in general in our country. It is, therefore a bit of counsel for our Trade unions that instead of opposing the present opening of choice for workers covered under ESI & other statutory Acts, they should cooperate to establish “Mechanism to bring Synergy between Ministry of Labor & Ministry of Finance (for IRDA monitored Insurance schemes)” to get the best Affordable Health care For Workers. It is important to stress the importance of minimum standard of health care and cash compensation in the contingencies of
illness, disablement, unemployment and death of workers. This is achievable provided following measures are adopted:-
(1) Strengthening of primary care services as contained in this Article.
(2) Popularization of Indigenous System of Medicines(ISM).
(3) Greater emphasis on Public Private Partnership (PPP Module) with active participation of Local self-Government bodies, NGOs, trade unions and corporate bodies.
(4) Use of Information Technology (IT) involving passing of bills, Inventory Management Et delivery of services involving high ended expenditure.
There is no Dearth of funds in the country but Dearth of Right Attitude to implement the above proposals. Let us strengthen Primary Health Care Facilities in our country as discussed in this Article to achieve as first step towards “Universalization Of Social Security” for our Workers which will go along way to bring “Skill Development & reduce Migration of Labour” in the long run- Whether it is “Ayushman Bharat”, Govt of India or “Biju Swasthya Kalyan Yojana” of Govt. of Odisha.
Campaign for Empowering Workers & Entrepreneurs on Safety, Social Security & Skill Development by Educating Women & Children that “Zero Accident & Disease at Workplace is Possible”
Former Insurance Commissioner (ESIC)/Communication Advisor, IRDA
Now@ Indo-German Focal Point for India
(Views Expressed are Personal.)