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印度寻求合适的全民健康覆盖(UHC)模式:在缺乏公民政治需求的情况下实施全民健康覆盖的风险。

India in search of right Universal Health Coverage (UHC) model: The risks of implementing UHC in the absence of political demand by the citizen.

作者信息

Kumar Raman, Roy Pritam

机构信息

President, Academy of Family Physicians of India, India; Chief Editor, Journal of Family Medicine and Primary Care, India.

Chairperson, Primary Care and Public Health Policy Forum, Academy of Family Physicians of India, India.

出版信息

J Family Med Prim Care. 2016 Jul-Sep;5(3):515-517. doi: 10.4103/2249-4863.197252.

Abstract

Amid the global push for Universal Health Coverage (UHC), the agenda is being set for India's health care. In the absence of a constitutional mandate, a national policy and citizen-led political demand for UHC, there exist specific risks in rushing toward its implementation in India. As the debate of UHC continues, the health-care delivery system in India is at cross roads. UHC in India could take two different trajectories. The first one takes India toward becoming "Global Bazaar" of morbidity and ill health, founded on the pillars of a vibrant rapidly multiplying healthcare industry. The other path takes India on a course of preventing wasteful, expensive health-care expenditure by maintaining healthy populations. A poor professional blood donor cannot become rich by selling his or her own blood beyond medically permissible levels; similarly, India cannot become a developed economy by merely allowing exploitation of disease, illness, and morbidity of her citizen. It is the duty of the state and governments to protect individual citizen, population under consideration, as well as country's economy from wasteful and potentially harmful expenditure incurred to address ill health. In the economic sense, any sensible UHC implementation mechanism would seek to regulate wasteful preventable health-care expenditure for the purpose of future economic stability and growth of the country. Due diligence toward safeguarding "public health in public interest," during the process of UHC implementation, is the need of the hour.

摘要

在全球推动全民健康覆盖(UHC)的背景下,印度医疗保健的议程正在制定中。由于缺乏宪法授权、国家政策以及公民对全民健康覆盖的政治需求,印度匆忙推进其实施存在特定风险。随着全民健康覆盖的辩论持续,印度的医疗服务体系正处于十字路口。印度的全民健康覆盖可能有两条不同的轨迹。第一条轨迹是让印度成为发病率和健康问题的“全球市场”,其基础是充满活力且迅速扩张的医疗行业。另一条道路是通过维持民众健康来防止浪费性、高昂的医疗支出。一个贫穷的职业献血者不能通过超出医学许可水平出售自己的血液而变得富有;同样,印度不能仅仅通过允许对其公民的疾病、病患和发病率进行利用就成为发达经济体。国家和政府有责任保护个体公民、相关人群以及国家经济,使其免受为应对健康问题而产生的浪费性和潜在有害支出的影响。从经济角度来看,任何明智的全民健康覆盖实施机制都将为了国家未来的经济稳定和增长而寻求规范浪费性的可预防医疗支出。在全民健康覆盖实施过程中,尽职保护“符合公共利益的公共健康”是当务之急。

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