Access to quality healthcare is a fundamental need of a country's citizens and lays the foundation for sustainable and equitable economic development. Over the last few decades, India has made significant progress on the primary healthcare front. However, a large section of the population still lacks access to critical healthcare services. The shifting disease pattern from communicable to non-communicable diseases has created a gap in the healthcare supply, increasing private sector participation.
The financial burden of attaining healthcare makes millions slip into poverty every year. Thus, healthcare needs in India are more complex and require a strong healthcare financing model with an efficient patient care pathway.
Universal Health Coverage (UHC) entails the availability and accessibility of preventive, curative, rehabilitative, and palliative health services, which are of adequate quality and do not place a financial burden on people availing services.
In 2017, the Indian Government introduced a National Health Policy (Ayushman Bharat or Healthy India) that aims to offer universal health coverage and provide the foundation for equitable healthcare. The National Health Protection Scheme (NHPS) initiative signals a shift in the Government's traditional role from the primary supplier of healthcare to a payer. Implementing such a large scheme in India is an ambitious task, and the long-term success will depend on many factors. As an enabler, the Indian government will need to invite participation from the private sector and not-for-profit organizations, while being prudent about regulations, technology assessments, pricing structures, quality of care, and infrastructure.
The success depends on aspects such as funding mechanisms, socio-economic factors, political will, focused implementation, and collaboration with the private sector to build the ecosystem. The government can mitigate some of these challenges by continuing to listen to the market, monitoring the situation, and adjusting the policy over time. Leveraging technology will be crucial not only in the implementation of the program but also in delivering outcomes and monitoring the system. From an industry perspective, the domestic market will see an increase in demand, which could trigger supply expansion. However, imports may increase if domestic manufacturing does not keep pace with the added demand. Such schemes with large scale implementation tend to increase the market size exponentially over the years.
In this paper, SKP examines the potential of the NHPS and attempts to study the impact it creates on healthcare accessibility along with opportunities created for various stakeholders in the industry. If successful, it will increase the healthcare spend per capita, ensure accessibility to India's underprivileged, and provide impetus to an already growing healthcare market. NHPS will be the beginning of a new era in universal health coverage in India. With the onset of UHC, the industry will benefit from a large patient influx, offering them a higher scale of operations. This will bring in more efficiency and quality control resulting in better health outcomes for patients creating a win-win situation. The scheme could be a game changer with "the power of a billion" bringing about a paradigm shift in the Indian healthcare ecosystem.
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