Bajpai Vikas, Saraya Anoop
Jawaharlal Nehru University, New Delhi, India.
Natl Med J India. 2010 Jul-Aug;23(4):231-5.
Despite the importance of healthcare for the well-being of society, there is little public debate in India on issues relating to it. The 'human capital approach' to finance healthcare largely relies on private investment in health, while the 'human development approach' envisages the State as the guarantorof preventive as well as curative care to achieve universalization of healthcare. The prevailing health indices of India and challenges in the field of public health require a human developmentapproach to healthcare. On the eve of independence, India adopted the human development approach, with the report of the Bhore Committee emphasizing the role of the State in the development and provision of healthcare. However, more recently, successive governments have moved towards the human capital approach. Instead of increasing state spending on health and expanding the public health infrastructure, the government has been relying more and more on the private sector. The public-private partnership has been touted as the new-age panacea for the ills of the Indian healthcare system. This approach has led to a stagnation of public health indices and a decrease in the access of the poor to healthcare.
尽管医疗保健对社会福祉至关重要,但印度在与之相关的问题上几乎没有公开辩论。为医疗保健融资的“人力资本方法”在很大程度上依赖于对健康的私人投资,而“人类发展方法”则设想国家作为预防和治疗护理的保障者,以实现医疗保健的普及。印度当前的健康指数以及公共卫生领域面临的挑战需要一种人类发展的医疗保健方法。在独立前夕,印度采用了人类发展方法,博雷委员会的报告强调了国家在发展和提供医疗保健方面的作用。然而,最近,历届政府都转向了人力资本方法。政府没有增加对健康的国家支出并扩大公共卫生基础设施,而是越来越依赖私营部门。公私伙伴关系被吹捧为解决印度医疗保健系统弊病的新时代万灵药。这种方法导致了公共卫生指数的停滞不前以及穷人获得医疗保健的机会减少。