On 28 August, 2017, the Karnataka Cabinet approved a Universal Health Coverage (UHC) Scheme, aimed at providing free medical assistance to 14 million households in the State. Dr Shalini Rajneesh, Principal Secretary, Department of Health and Family Welfare, Government of Karnataka, shares the details of UHC, its key objectives and roadmap, in an interview with T Radhakrishna of Elets News Network (ENN).
“Aarogya Bhagya (free healthcare) is the latest in a long list of popular schemes offered by the state government. Healthcare facilities will be provided through an Aadhaarlinked universal health card. The scheme will become operational on November 1, 2017.”
How significant is the UHC and its benefits for public?
Karnataka is the first state in the country to announce UHC for its people with effect from November 1, 2017. The implementation of UHC in Karnataka is in tandem with the global developments of achieving new health goals under State Development Goals-3.
UHC in Karnataka will enable access to free primary, secondary and tertiary to care to all persons with special benefits to deprived actions of society. The non-deprived categories are given an option to enroll @ Rs 300 per annum for rural and @ Rs 700 per annum for urban areas. Primary care would be available free of cost across all institutions. For secondary care, government hospitals will provide free treatment for 1,000 procedures and 500 additional procedures would be provided free of cost in collaboration with private sector. Tertiary care would be provided in both government and identified private institutions, with whom the government has signed a memorandum of understanding.
What are the efforts going into the scheme and needful resources being created as part the above scheme?
UHC in Karnataka will converge seven existing schemes e.g. Vajpayee Arogya Shree (VAS – 69% outreach) for BPL; Rajeev Arogya Bhagya (RAB-19% outreach) for APL; Jyothi Sanjeevini Scheme (JSS- 5% outreach) for State Government employees; for cooperative farmers (Yeshaswini), for children Rastriya Bal Swasthya Karyakram (RBSK) and for road traffic accident victims Mukhya Mantri Harish Santhvana (MSHS) and other departments like Education, Women and Child, Labour, Rural Development health schemes will all get converged within the umbrella of UHC.
UHC cards linked to Aadhaar will be made available to the patients to prevent overlap and duplication of funds. Pooling of resources from various existing state and central government schemes amount to Rs 1,000 crore would provide financial sustainability to UHC. Better awareness both at the field level, through ASHA/ ANMs, on different packages, hospitals empanelled, entitlements, etc. is being carried out to build clarity among people to call one helpline no. through single scheme to allow easy navigation of patients without any red-tapism.
Who are the key stakeholders of the scheme and expected budget allocations for the implementation of the scheme?
The key stakeholders of the scheme would include the diverse units under the Health Department starting from PHC/CHC/Taluka and District Hospitals. Besides, superspecialty hospitals called Centres of Excellence under medical Education and Government Medical Colleges will take a huge responsibility for Secondary (70%) and Tertiary care (30%).
Further, to initiate the enrolment process, sufficient coordination efforts are being made with Food and Supplies department and Panchayati Raj department to get most accurate information of beneficiaries from deprived and vulnerable sections of the State. State has also initiated the process of finalising MoUs with the hospitals and doctors who would provide care under the UHC scheme. Simultaneously, coordination efforts are being conducted at field level where both the community and community workers (ASHAs, ANMs etc.) are being mobilised as they would play a key role in making UHC a successful scheme in Karnataka.
What are the expectations of the government from the scheme and opportunities available for the private sector in the scheme?
The UHC scheme is expected to put Karnataka at the forefront of providing free and extensive healthcare to a wider variety of its population thereby serving as a model for other States. UHC is expected to tackle the problem of high out of pocket expenditure around Rs 5,000 per person and provide its citizens with a protective net of health assurance sponsored by the State.
In this regard, ample opportunities will open up for private sector to collaborate with the government. Since private sector pioneers in some of the super specialty care, trauma services etc. attract highly talented manpower, the same could be integrated to work with the government and carry forward the UHC agenda. Private sector can contribute in both aiding the State in providing services as well as promoting state of art research in development of new drugs and devices which could make health-care more qualitative and affordable. Further opportunities for private sector will open in newer areas where the Government is venturing, e.g. telemedicine, teleradiology, IT linkages through E-hospitals, mobile apps, etc.
The CSR initiatives are on the rise in the State. Your plans from department for spreading the right message to private and public participation?
There have been many activities which the State has undertaken especially in the field of IT where private partnership and CSR has yielded positive results. The State is attempting to capture the individual health data at source by giving tablets to ANMs.
Here, Samsung has joined hands with the State and has distributed few thousand TABS to ANMs. Apart from that SAST will also give Tabs to its Arogyamitras. Similarly, Biocon Ltd has started doing pilot with us at some PHCs using diagnostic software to ensure that IT is used to the extent possible.
Food safety is a concern, kindly share some important steps in the State? Similarly for drugs control.
Attempts are being made for setting up HTA (Health Technology Assessment) cell with support from bodies such as the World Bank. Such expertise will aid the State in monitoring areas such as Drug control etc.
Food Safety cadre has been now created. Besides, training is given to collaborative department officials like Rural and Urban Development, where in trade licensing authorities are made to review and regulate the observation of FSSAI mandates. A ‘Healthizen’ mobile app is launched to take feedback from people about rampant food safety violations.