At long last, public health is on the agenda of the country’s policy makers. The Prime Minister’s Republic Day speech mentioned that the Twelfth Plan would focus on health just as the Eleventh Plan had focused on education. But the manner in which the education sector has been messed with does not give much cheer on the prospects for public health at the end of the Twelfth Plan. Nevertheless, it is encouraging that in the last one year universal health coverage (UHC) has emerged as a goal for the planners. Both the High Level Expert Group (HLEG) set up by the Planning Commission in October 2010 and the Planning Commission’s Steering Committee on Health for the Twelfth Plan have discussed public health related issues from the perspective of achieving UHC by the end of the Thirteenth Plan.
However, while the reorientation of the approach and the overall premise suggested by the HLEG in its report of November 2011 are sound and many of its recommendations are worthy of implementation, setting a tight deadline of a decade to achieve UHC may be infeasible given the many ills of the public health care system and the largely unregulated market-driven situation in which it functions. The Steering Committee has incorporated some elements of the HLEG report within an altered framework that differs on key aspects from the HLEG’s perspective. It is the Steering Committee that will have a definitive influence on the decision-making process.
But before the government begins to implement the Steering Committee’s recommendations, there is the need for a wider public debate on them because at least some of the recommendations would let the private sector continue to play a prominent role in health care and make the objective of UHC difficult to achieve. More pertinently, in many key components of the health care system the regulatory framework is either lacking or ineffective and