Health Policy and Legislation

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With the setting up of the health technology assessment board, evidence from cost-effectiveness analysis will play an important role in decision-making. This raises the fundamental question: How much extra cost per unit of health gained is considered cost-effective? Various approaches for assessing the appropriate cost-effectiveness threshold for India are discussed. A robustly determined opportunity cost of healthcare spending should serve as a proxy for setting up a CET, and it should be used to advocate for greater resources towards achieving universal health coverage.

The lack of reliable, cause-specific mortality statistics is considered a major obstacle to the improvement of public health in many low- and middle-income countries. Researchers and government officials in India have set up the Million Death Study to address this situation. First, how the study produces quantitative estimates of the burden of mortality in India is explored by collecting symptomatic data, using that data for diagnostic purposes, and aggregating those diagnoses into an overview of mortality in India. Second, the limitations of the perspective on public health based on discrete and specific diseases that result from this approach are addressed. Numbers alone cannot solve the public health issues India faces, rather cognitive justice towards a broader range of perspectives on major public health problems is required to develop effective political interventions.

Based on a critical review of the NITI Aayog’s recently published “Healthy States, Progressive India,” it is argued that the report provides only a superficial insight into the overall health attainment. Much deeper and careful analysis is required if one aims to unfold the complexity and varied contexts provided by Indian states, let alone ranking them on health attainment. The method of calculating the index in the report compromises scientific rigour, and the inferences drawn are highly misleading.

Examining how health policy has fared in India during the last five years shows the constriction of finances for major programmes like the National Health Mission and Reproductive and Child Health Programme that has led to under-resourced public systems. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana health insurance scheme would only end up diverting public resources towards commercial insurance companies and private hospitals, while having doubtful benefits for community health.