The draft report of Planning Commissions Steering Committee on Health for the 12th Five-Year Plan advocates free medicines for all in public health facilities. This is in line with the recommendation of the High Level Expert Group (HLEG) on Universal Health Coverage (UHC) that submitted its report a couple of months ago.
The draft also envisages rolling out of a cashless UHC facility in one district per state during the first year of the 12th plan before being extended to the entire country.
The report stresses on the development of a biometric-based health information system a recommendation,which,if accepted,could reignite the debate about whether the UID should be made compulsory. A Health Ministry sub-committee on digitisation of health data has recommended UID as the basis of the exercise.
Among the primary healthcare targets that the report tries to set are reduction of maternal mortality rate to 1 per 1,000 live births from the current 21,reduce infant mortality rate to 28 per 1,000 from 47,reduce undernutrition in girls of less than three years of age from 40 to 20 per cent and reduce anaemia among women from 56 to 28 per cent. It seeks to increase child sex ratio in the 0-6 years age group from 914 to 935.
The report points out that medicines are the biggest contributor to out of pocket (OOP) spending of households. According to estimates of National Health Accounts 2004-05,71 per cent healthcare costs are financed by OOP expenditure and hence,the 12th plan should focus on ensuring access at all times to all essential medicines in every public facility through adoption of the model of the Tamil Nadu Medical Services Corporation (TNMSC) and by promoting use of generic drugs. The TNMSC procures drugs,vaccines through tenders and makes them available to all government facilities in the state. The first step in the direction has been taken with the Cabinet approval for a Central Procurement Agency.
On UHC,the draft report says: Providing Essential Health package (EHP) covering out patient and in patient healthcare as an entitlement to every resident family. Core components of the EHP would be finalised by the Centre so that the total expected cost is within Rs 3,000 per family per year,with 2/3 going to ambulatory care and remaining to inpatient care.