Context:

• India’s healthcare policy under the current government has undergone a paradigm shift — from being viewed as welfare expenditure to becoming an investment in human capital.
• This reorientation aligns healthcare with the vision of building a Viksit Bharat (Developed India) by 2047, ensuring equity, economic productivity, and social transformation.

Evolution of Healthcare Policy in India - Gujarat Model:

• The 108 Emergency Ambulance Service brought rapid medical attention to rural and urban communities.
• Simultaneously, POSHAN, a nutrition programme for tribal and rural children, addressed micronutrient deficiencies and laid a foundation for better learning outcomes.
• Lesson learned: Investing in prevention pays dividends in productivity and prosperity.

Major National Initiatives Since 2014:

• Ayushman Bharat (2018):
  • Overview: It has become the world’s largest publicly funded health insurance scheme, covering over 55 crore economically vulnerable citizens.
  • Outcomes: Prevents households from slipping into poverty due to catastrophic health expenditure. Encourages private hospital upgrades in Tier-2 and Tier-3 cities.
• POSHAN Abhiyaan (2018):
  • Targets pregnant women, lactating mothers, and children.
  • Focus on supplementary nutrition, growth monitoring, and behavioural change.
  • Long-term impact: Enhances cognitive development and higher future earnings.
• Jan Aushadhi Kendras: Over 16,900 Jan Aushadhi Kendras supplying quality generics at steep discounts, and reducing out-of-pocket (OOP) expenditure on healthcare.
• Swachh Bharat Mission:
  • Though often framed as a sanitation drive, it is equally a public-health revolution.
  • Constructed millions of toilets across villages and towns, and have drastically reduced open defecation, cutting water-borne disease and saving an estimated 60,000-70,000 infant lives annually.
  • According to UNICEF, each rural family has estimated savings of Rs 50,000 per year thanks to the mission.
• Women-centric and digital health initiatives:
  • Beti Bachao Beti Padhao have improved gender ratios and promoted girls’ education.
  • Digital health tools and Ayushman Arogya Mandirs are bringing screening, teleconsultation, and electronic health records to even the smallest communities.

Economic Logic of Healthcare Reforms:

• Decline in OOP:
  • Reduced from 64% of total spending in 2013-14 to 39% in 2021-22.
  • This shift is largely attributed to expanded insurance, subsidised medicines, and sanitation improvements.
  • Lower personal spending on illness translates into higher household consumption, greater savings, and stronger participation in formal finance.
• Positive externalities:
  • Fewer sick days results in higher workforce productivity.
  • Healthy children lead to better education outcomes and higher lifetime earnings.
  • Benefits urban employers as healthier migrant workers reduce staff turnover and training costs.
• Catalyst for private sector growth:
  • Insurance-backed demand stimulated private investment in hospitals, labs, and start-ups.
  • Employment generation and infrastructure expansion in underserved areas.

Strengthening Medical Education:

• In 10 years, the number of medical colleges has grown to 780 from 387 in the last 60 years.
• Today, India produces over 1,18,000 doctors every year, the most in the world.
• Significance: Expands skilled human resources for India’s growing healthcare needs.

Way Forward:

• Healthcare as human capital investment: Highlights shift from welfare to productivity-enhancing strategy.
• Preventive approach: Through clean water, nutrition, sanitation must remain central.
• Inclusive growth: Women’s empowerment, reduced OOP spending, and digital health will ensure equity.
• Economic transformation: Healthcare reforms contribute directly to household savings, higher incomes, and job creation.
• Future vision: By 2047, cumulative dividends will reflect in longer life expectancy, healthier workforce, and India’s transition into Viksit Bharat.