Context: Although Atmanirbhar Bharat Abhiyan stimulus package focuses on reviving economic activities, restoring livelihoods, addressing concerns of hunger and starvation, stimulating small and medium enterprises, and enhancing farm incomes but the health sector has not received much attention.
Challenges associated with our Health care System
Poor state of healthcare facilities:

• The healthcare delivery system in most States is extremely fragile given the poor state of primary healthcare facilities.
• The public provisioning of healthcare has been found to be insufficient, of poor quality and having limited reach.

Poor resource allotment to health sector:

• The public spending on health has been consistently low at around 1.15% of GDP for well over a decade.

Opportunity cost of COVID-19 pandemic:

• It is possible that resources allocated for other health programmes are being diverted to deal with the COVID-19 pandemic. The opportunity cost of such diversion of funds could be high.
• People’s access to routine maternal and child health as well as family planning services in parts of the country has been negatively impacted. Progress made with respect to various diseases could witness setbacks.

Limitations of private sector:

• India’s private sector in health is sizable.
• The private sector accounts for 93% of all hospitals, 64% of all hospital beds, and 80-85% of all doctors.
• Most private healthcare providers seem to be incapable of and unwilling to help even during a national crisis.
• Rapidly declining revenues and sharply eroding profits are leading to the closure of many private hospitals.
• Only a few private providers have come forward to extend support to the government.

What need to be done?
Strengthening public health:

• The COVID-19 pandemic experience has brought out the critical importance of the public sector in health provisioning.
• There is a need to invest in universal health coverage (UHC) by reversing the financial neglect of public healthcare. Nearly every country in the world that has achieved anything like UHC has done it through the public assurance of primary healthcare.

Increasing investments in health:

• There is a need to urgently and immediately step up investments in health.
• A new ‘health investment plan’ (as part of the stimulus package), at least 1% of the GDP, out of the stimulus package should be earmarked for improving the country’s health infrastructure and strengthening public health service delivery.

Prioritizing primary healthcare:

• Up to 70% of the additional expenditures should be ring-fenced for primary healthcare and further strengthening health and wellness centres, primary health centres and community health centres.
• This would enable the State governments to be better prepared to face a second round of the pandemic.