On the Universal Health Coverage Day, the World Health Organisation (WHO) released its 2024 Global Health Expenditure Report, revealing troubling declines in government health spending. December 12 is celebrated as the Universal Health Coverage Day across the globe.
The report, titled Global Spending on Health: Emerging from the Pandemic, shows a reduction in per capita government health expenditures in 2022 across all income groups, following a surge during the early COVID-19 pandemic years, thereby undermining the efforts towards achieving UHC as part of the UN's Sustainable Development Goals.
This year, Universal Health Coverage Day emphasises the urgent need for governments to prioritise financial protection, ensuring access to essential health services for all without risking financial hardship.
As per the UN, 4.5 billion people worldwide lack access to basic health services, and 2 billion experience financial hardship from healthcare costs.
“While access to health services has been improving globally, using those services is driving more and more people into financial hardship or poverty,” said Tedros Adhanom Ghebreyesus, WHO Director-General.
The 2024 UHC Day theme, ‘Health: It’s on the Government’, underscores the role of governments in ensuring equitable and affordable healthcare for all.
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In India, given that health spending is majorly an out-of-pocket expense, for a cross-section of people, Universal Health Coverage assumed significant importance. The central government's Ayushman Bharat programme provides 12 services free of cost and insures 50 crore economically weaker persons for Rs 5 lakhs sum assured.
Yet, those on the margins are seldom able to access quality healthcare in community health centres because of a lack of staff, lack of facilities and general apathy and are often referred to faraway district hospitals where they add to the overcrowding. The perception that quality healthcare can be available only to those who have the money, remains ingrained in public consciousness.
Even as it is widely accepted that The Ayushman Bharat scheme has played a significant role in achieving a comprehensive healthcare system by leveraging digital health methods and technologies, experts have also criticised the government's flagship program saying that while it has achieved a large coverage of the population, but it has not improved utilisation of the facilities, quality of care provided, and financial protection. Private hospitals contracted under the scheme have continued to overcharge patients.
In the Pubmed Central, author Rajesh Kamath, from the Prasanna school of Public Health at Manipal Academy, says that a critical review of the impact of Yojana was carried out and a few themes stood out after the review.
These were "out-of-pocket health expenditure (OOPHE), fraud, upcoding and provision of unnecessary medical care, moving focus away from primary care, lop-sided access, exclusion at the periphery, and brain drain.
The researcher further mentioned that "Continual recalibration and course corrections on the basis of high-quality feedback might enable ABPMJAY to reduce catastrophic OOPHE for 500 million Indians. This is more than 6% of humanity: the largest block of people served by a single PFHI in history."