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Health coverage schemes must provide widest coverage: Venkaiah Naidu

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New Delhi: The Vice President of India, Shri M. Venkaiah Naidu has said that there is a need to create health coverage schemes that provide widest coverage to the young, aged and infirm and those suffering from both critical acute and chronic ailments. He was addressing the gathering after launching the Atal Amrit Abhiyan by Assam Government, which seeks to provide access to quality medical care to 3.2 crore people, in Guwahati, Assam today. The Governor of Assam, Prof. Jagadish Mukhi, the Chief Minister of Assam, Shri Sarbananda Sonowal, the Minister for Health & Family Welfare, Assam, Dr. Himanta Biswa Sarma and other dignitaries were present on the occasion.

The Vice President called on the private sector to supplement the efforts of the government in a big way in reaching out medical care to the people in rural areas. He further said that quality of health services should be good enough to improve the health of those receiving services. People should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm, he added.

The Vice President said that modern day lifestyle is leading to various non-communicable diseases and said that efforts are needed to arrest the growing incidence of such disease which is affecting even the young.  There has to be concerted efforts from all stakeholders in healthcare to raise awareness among the people on the dangers of leading sedentary lifestyles, eating junk food, harmful use of alcohol and tobacco, he added.

The Vice President stressed on the need to change school curriculum include lessons on NCDs and physical exercises should be made mandatory for school and college students. Wherever possible, yoga asanas should also be taught to children, he added.

The Vice President said that north-eastern States like the rest of India are facing shortage of medical manpower and medical facilities in rural areas. This shortage has to be bridged by opening more medical colleges and setting up more number of healthcare facilities in the rural places, he added.

Following is the text of Vice President’s address:

” I am extremely pleased to launch Assam Government’s Atal Amrit Abhiyan, one of the largest health cover schemes, which seeks to provide access to quality medical care to 3.2 crore people.

I would like to compliment the Assam government for initiating this scheme with the objective of providing health cover to 92 per cent of the State’s population by including BPL and APL ( above poverty line with an annual income up to Rs. 5 lakh) families. I am told that those covered by the scheme will get quality tertiary medical care for six specialties requiring hospitalization for surgeries and therapies. They will be getting the medical care through an empanelled network of hospitals—public and private hospitals within and outside the State.

I am also told that 438 procedures with the six specialties have been approved for treatment in empanelled network hospitals. The six disease groups identified for financial support are:  Cancer, heart disease, kidney disease, neurological disorder, neonatal diseases and burns. The enrolment is free for those from BPL families while members from APL families will have to pay a nominal sum of Rs.100 for enrolment and renewal.

As you all are aware, out of pocket medical expenses make up about 62% of all healthcare costs in India. This is extremely high and leads to catastrophic financial, social and emotional consequences, often reducing our poor and low income families to penury.

According to a new report from the World Bank and the WHO, at least half of the world’s population cannot obtain essential health services. And each year, large number of households is being pushed into poverty because they must pay for health care out of their own pockets. Currently, world over 800 million people spend at least 10 percent of their household budgets on health expenses for themselves, a sick child or other family member.

It is estimated that the number of Indians falling below the poverty line (BPL) due to health spending may run as high as 63 million people: almost 7% of the nation’s population. The need of the hour is to safeguard people from this catastrophic health care expenditure while providing comprehensive care at the time of need.

India is embarking on an ambitious target of achieving Universal Health Coverage by ensuring equitable access for all Indian citizens, regardless of income level, social status, gender, caste or religion.

The aim is to provide affordable, accountable, appropriate health services of assured quality (promotive, preventive, curative and rehabilitative) as well as public health services to individuals and populations, with the government being the guarantor and enabler, although not necessarily the only provider, of health and related services.

Achieving universal health coverage is the goal of most countries. WHO stated that UHC embodies three objectives: “Equity in access to health services – everyone who needs services should get them, not only those who can pay for them; The quality of health services should be good enough to improve the health of those receiving services; and people should be protected against financial-risk, ensuring that the cost of using services does not put people at risk of financial harm”.

Therefore, there is a need to create health coverage schemes that provide widest coverage to the young, aged and infirm and those suffering from both critical acute and chronic ailments.

Sisters and brothers, India is facing a peculiar twin burden of communicable and non-communicable diseases. While, we have done fairly well in eradicating some of the communicable diseases like polio and tetanus, we cannot remain complacent and must continue the fight against all communicable diseases with renewed vigour, especially MDR-TB, which is posing a major health concern. Similarly, we cannot lower our guard against HIV and the opportunistic infections caused by it due to weakened immune systems.

At the same time, we have to arrest the growing incidence of various non-communicable diseases, which are affecting even the young–diabetes, heart ailments, stroke, cancers, obesity and chronic respiratory diseases. Modern day lifestyle is leading to NCDs, which surprisingly are not confined to urban areas alone.

There has to be concerted efforts from all stakeholders in healthcare to raise awareness among the people on the dangers of leading sedentary lifestyles, eating junk food, harmful use of alcohol and tobacco. The school curriculum should include lessons on NCDs and physical exercises should be made mandatory for school and college students. Wherever possible, yoga asanas should also be taught to children. According to WHO, the NCDs are the world’s largest killer with an estimated 38 million deaths annually. Of them, 16 million are premature deaths (under 70 years of age).

Therefore, it is important to minimize the risk factors to reduce the deaths caused by NCDs.

The National Family Health Survey IV shows that about 29.8 per cent children below the age of 5 years in Assam are underweight, while 35.7 children between 6-59 months are anaemic. The Infant Mortality Rate (IMR) in Assam stands at 44 per 1,000 live births as against national average of 37. The Maternal Mortality Rate (MMR) is 300 per 1,00,000 live births as against the national average of 167. I am sure the Assam government is taking the needed measures to   bring down IMR and MMR further.

The north-eastern States like the rest of India are facing shortage of medical manpower and medical facilities in rural areas. This shortage has to be bridged by opening more medical colleges and setting up more number of healthcare facilities in the rural places. Besides, there is also a need to impart training to more number of para-medical personnel. One of the ways to address this problem is to make it mandatory for MBBS graduates to serve in rural areas. Doctors, who serve in rural areas should be given preference in admission to PG medical courses.

Sisters and Brothers, India has less than one doctor for every 1,000 population, which is below the WHO norm. The doctor-population ratio is estimated to be 0.62:1 as per current population, while the number of hospital beds is estimated to be 0.5 per 1,000 people.

The private sector must supplement the efforts of the government in a big way in reaching out medical care to the people in rural areas.

While there is every need to increase health insurance penetration in India, I am happy that the Government has recently announced Aayushman Bharat to provide health cover to 10 crore families and plans to set up 1.5 lakh health and wellness centres. Ayushman Bharat is aimed at providing affordable healthcare to 500 million economically deprived people and will cost the exchequer Rs.12,000 crore annually.

I am sure Atal Amrit Abhiyan will be dovetailed with Ayushman Bharat to increase the well being of the people of Assam.

Before concluding, I would like to once again compliment the Assam Government for launching this innovative scheme by including 438 procedures within six specialties. However, I would like to caution the government to monitor its implementation with a hawk eye as there is a danger of its misuse by those implementing it.

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