The UPA government may roll-out its free health coverage to all through a pilot in each district of the country before next generation elections in addition to direct cash transfer.
Universal free health coverage (UHC) was the big promise Prime Minister Manmohan Singh made at his Independence Day speech this year and the government is now working on a road map to implement it.
“The Universal Health Coverage would take two plan periods for realization, but a move in terms of pilots and incremental coverage would begin in the 12th five year plan,” said the plan document to be approved at National Development Council (NDC) meeting on Thursday.
The free health coverage will be executed through primary health care centers, which would act as gateway to secondary and tertiary care facilities.
“Private sector will be contracted in only for critical gap filling,” the document said, adding that no fee of any kind will be levied on primary health care services.
The Central government wants the state to run at least one, if not three, pilot in each district to test the efficacy of programme. The medical colleges would be asked to monitor the pilots for their cost-effectiveness.
Before rolling out the pilots, the planning commission wants the government to work-out cashless delivery of an essential health package (EHP), which would include free out and in-patient care and free generic medicines.
It also wants the make UHC part of the district health plan and frame comprehensive standard treatment and referral guidelines, apart from registering all families in a particular area for coverage.
The panel has also suggested that sin tax on cigarette and alcohol, a cause for many diseases, can be imposed to fund the initiative.
In addition, the panel has suggested to include health in infrastructure sector so that private players can be provided up to 20% viability gap funding.
The commission has also said the states can learn from similar universal health programmes in Sri Lanka, Thailand and Mexico.
In Sri Lanka, free outpatient services are provided through pubic providers and secondary and tertiary services through public and private providers. In Mexico, the entire public health programme is funded through public money.
*Free Universal Health Coverage to be provided in next five years
Full immunization among children under three years of age and pregnant women.
Full antenatal, natal and post-natal care
Skilled birth attendance with a facility for meeting need for emergency obstetric care
Vaccines for hepatitis B and C for high risk groups
108 universal ambulance service across India
HIV testing and counseling during antenatal care
Free medicines to HIV positive mothers to prevent mother to child transmission.