Introduction

Vision 2020 – Heath Care

The U.S. Institute of Medicine in its report (IOM, 1988) defined public health as “Public health is what we,
as a society, do collectively to assure the conditions in which people can be healthy.” It is the collective
effort put by the government and its officials to promote, protect and preserve the people’s health.
However, it is only effective when an equivalent amount of community effort is reciprocated.

CEA Winslow also included this aspect of public health and defined it precisely as, “The science and art of
preventing disease, prolonging life and promoting health and efficiency through organized community
effort.”

Assessment of community needs, sustainable development and assurance lie at the core of the public
health functions. This identifies that public health has a multidimensional approach with a social,
managerial as well as economic perspective towards improving the health of the people through a plethora
of activities, which include health promotion, community outreach, resource mobilization, epidemic and
disaster prevention and management, protection against environmental hazards, monitoring and
evaluation, epidemiological surveillance, research, policy and planning, and so on.
 Introduction
Vision 2020 – Heath Care

• Indian healthcare delivery system is categorized into two major components  public and private.
The Government, i.e. public healthcare system, comprises limited secondary and tertiary care
institutions in key cities and focuses on providing basic healthcare facilities in the form of primary
healthcare centers (PHCs) in rural areas. The private sector provides majority of secondary, tertiary,
and quaternary care institutions with major concentration in metros and tier I and tier II cities.

• India's competitive advantage lies in its large pool of well-trained medical professionals. India is
also cost competitive compared to its peers in Asia and Western countries. The cost of surgery in
India is about one-tenth of that in the US or Western Europe.
 Health Care in India

• The size of Indian Healthcare sector is expected to reach $ 280 billion by 2020 as per some
reports. Healthcare industry in India comprises hospitals, medical tourism, health insurance,
medical equipment, telemedicine, outsourcing, clinical trials, medical devices.

1. The multiple reasons for growth are increased diseases due to lifestyles, rising income, greater
health awareness, improved access to insurance.
2. As per 2016 report India had reduced the Maternal Mortality Ratio (MMR) by around 26% since
2013.
3. The hospital industry is expected to reach approximately $ 132 billion by 2022.
4. 74% of expenditure in the healthcare sector comes from Private sector.
5. Medical tourism segment in India is growing at the rate of 18% and it is expected to reach $ 9
billion by 2020.
 Growth of Healthcare Industry
• Indian healthcare sector is expected to reach US$ 193.83 billion by 2020. Rising income level,
greater health awareness, increased precedence of lifestyle diseases and improved access to
insurance would be the key contributors to growth. Health insurance is gaining momentum in India.
Gross direct premium income underwritten by health insurance grew 17.16% to to Rs. 51,637.84
crore (US$ 7.39 billion) in FY20. According to Economic Survey 2020-21, the health insurance
industry experienced increasing insurance coverage in FY20. The number of households in Bihar,
Assam and Sikkim that had health insurance increased by 89% in FY20, as compared with FY16.
• The country had 393 Ayurveda and 221 homeopathy Government recognized colleges.
• As of April 2020, number of sub centers reached 169,031 and number of primary health centers
(PHCs) increased to 33,987.
• The hospital industry size is estimated to touch US$ 193.83 billion by 2020 and US$ 372 billion by
2022.
Central Government Schemes – Healthcare Sector in India

Health is a state subject, the Central Government supplements the efforts of the State Governments in delivery of health
services through various schemes for primary, secondary, and tertiary care.

1.By 2025, the Government of India is planning to increase the expenditure on Health care to 2.5% of the GDP.
2.In the Union Budget 2020-21, the Ministry of Health and Family Welfare was allocated a budget of more than Rs
65,000 crores. 
3.In Budget 2020-21, Government of India has approved the extension of National Health Mission with an allocated
budget of around Rs 34,000 crores.
4.The National Nutrition Mission has set an objective of reducing the under nutrition, problems of stunting by 2%
5.The Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PMJAY) – This is the largest health care program funded
by the Government. 
6.In the Union Budget 2020-21, PMJAY was allocated a budget of more than Rs 6400 crores.
7.As of Nov 2019, more than 63 lakh people have received free treatment under Ayushman Bharat – PMJAY.
8.In the Union Budget 2020-21, Government of India allocated Rs 3,000 crores for Pradhan Mantri Swasthya Surakhsa
Yojana (PMSSY).
Ayushman Bharat or Pradhan Mantri Jan Arogya
Yojana (AB-PMJAY)
• The government scheme to make healthcare facilities available and accessible to the economically weaker
segment of the population, is indeed one such step. A September 2019 estimate suggests- 18059 hospitals are
already under its purview, with over 4,406,461 people admitted and more than 10 crore e-cards issued. The
year 2020 will see further footsteps to empanel more healthcare providers, especially in small towns, towards
the aim of having 1.5 lakh health and wellness centers and covering at least 50 crore beneficiaries from 10
crore financially vulnerable families under Rs 5 lakh per family, per year coverage in secondary and tertiary
care hospitalization, by 2022.
Associated Challenges With Public Health Systems in India

•Lack of Primary Healthcare Services: The existing public primary health care model in the country is limited in scope.

•Even where there is a well-functioning public primary health center, only services related to pregnancy care, limited childcare and
certain services related to national health programmes are provided.
•This represents only 15% of all morbidities for which people seek care.

•Supply-Side Deficiencies: Poor health management skills and lack of appropriate training and supportive supervision for health
workers prevent delivery of the desired quality of health services.

•Inadequate Funding: Expenditure on public health funding has been consistently low in India (approximately 1.3% of GDP). As
per OECD, India's total out-of-pocket expenditure is around 2.3 % of GDP.

•Overlapping Jurisdiction: There is no single authority responsible for public health that is legally empowered to issue guidelines
and enforce compliance of the health standards.

•Sub-optimal Public Health System: Due to this, it is challenging to tackle Non-communicable Diseases, which is all about
prevention and early detection.

•It diminishes preparedness and effective management for new and emerging threats such as pandemic like Covid-19.
 Steps To Be Taken
• Enabling Preventive Care: In order to promote preventive care, the Union government has announced the
conversion of primary health care centers into Health and Wellness Centers (HWCs). These HWCs will act as
the pillar of preventive care and ‘gateway’ for access to secondary and tertiary health services.

• Bringing Behavioral Change: There is a need to ensure people eat right, sleep right, maintain good hygiene,
exercise, and adopt a healthy lifestyle that necessitates concerted interventions at various levels of the system.

• Cooperative Federalism: State governments should be incentivized to invest in creating a dedicated cadre
for public health at the state, district and block levels.

• More Funding: Public funding on health should be increased to at least 2.5% of GDP as envisaged in the
National Health Policy, 2017.

• Decentralization: There is a need to make nutrition, water, sanitation and hygiene (WASH) part of the core
functions of Panchayati raj institutions and municipalities.
 Conclusion
• India is a land full of opportunities for players in the medical devices industry. The country has also become one of
the leading destinations for high-end diagnostic services with tremendous capital investment for advanced
diagnostic facilities, thus catering to a greater proportion of population. Besides, Indian medical service consumers
have become more conscious towards their healthcare upkeep.

• Pandemics such as Covid-19 starkly remind us that public health systems are core social institutions in any society.
The government has made several efforts to address the shortfall in the public health system through the schemes
like the National Medical Commission (NMC) Act, 2019, Pradhan Mantri Bhartiya Janaushadhi Pariyojana,
Pradhan Mantri - Jan Arogya Yojana etc. However, the need of the hour is an adequate investment, for creating a
health system that can withstand any kind of public health emergencies, deliver universal health coverage and meet
the targets of the Sustainable Development Goals.

• The Government of India is planning to increase public health spending to 2.5% of the country's GDP by 2025.

• India's competitive advantage also lies in the increased success rate of Indian companies in getting Abbreviated
New Drug Application (ANDA) approvals. India also offers vast opportunities in R&D as well as medical tourism.
To sum up, there are vast opportunities for investment in healthcare infrastructure in both urban and rural India.