National Health Assurance Mission (NHAM) - Overview and Government Proposals

What Prompted the Need for the National Health Assurance Mission?

1. India's public health spending was around 1% of its GDP.
2. The public health system was not efficiently managed, resulting in suboptimal use of government funds.
3. Unethical practices were rampant in the private medical sector.
4. The regulatory structure was inadequate.
5. The health ministry aimed to increase health sector spending to 2.5% of the GDP.
6. India's public healthcare expenditure was among the lowest in low and middle-income countries.
7. India's public health expenditure was significantly lower than the World Health Organisation's (WHO) recommended 5% of the GDP.
8. The Government of India sought to infuse transparency, efficiency, compassion and accountability into the public health system.

The Government of India could use the lessons from the National Rural Health Mission (NRHM) to shape the National Health Assurance Mission (NHAM).

1. Insurance does not guarantee assurance.
2. The healthcare sector was plagued by information asymmetry.
3. The regulations were weak.
4. There were potential market failures.

Here are some important Government Missions related to healthcare:

Proposals by the Ministry of Health for the National Health Assurance Mission (NHAM)

1. Establishing a powerful regulatory authority to enforce quality standards across the board.
2. Ensuring consumer protection.
3. Universal Health insurance was to be a significant part of this scheme.
4. Provision of free drugs to patients.
5. Provision of free diagnostic services.
6. Considering insurance coverage for severe and costly diseases requiring heart surgery or organ transplant.

Why Didn't the National Health Assurance Mission Come to Fruition?

1. The healthcare plan was estimated to cost $18.5 billion over five years.
2. The Government's budget was focused on enhancing infrastructure to stimulate economic growth, leaving less funds for the social sector.
3. The Union budget only increased the health department's budget allocation by a marginal 2%, which was below the inflation rate at the time.

The information provided above will aid candidates in their preparation for the UPSC 2021 exams.

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