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Universal Health Coverage - Frequently Asked Questions

What does Universal Health Coverage entail for India?

"Universal coverage" refers to a scenario where everyone is covered for basic healthcare services. This is a scheme, under which all Indian citizens, regardless of their economic, social or cultural backgrounds will have the right to affordable, accountable and appropriate health services of assured quality defined in a published package of services and benefits. It is also a supplemental system of financing to protect people from increasing medical expenses.

Why is UHC being offered now?

It is important for all Indians to have access to quality health care regardless of your financial status such as where you live or how much income that you earn. It is also necessary for us to improve the quality of health care at our hospitals and other health care institutions.

Who will pay for it?

Access to health care will be paid for by the Government of India, with funds generated through taxes along with an increased spending on public health to pay for the health services given to citizens. The system will be ‘cashless’ where patients will not be charged any user fees for health care services provided.

What services will be available?

Every Indian citizen will be covered by a National Health Package that has a choice of facilities that are guaranteed by the government. The package will cover, free-of-charge, all Primary, Secondary and some Tertiary care services.

How can one avail of services?

The process of providing you with quality health care under this new system is an easy one. To access the health benefits offered you must first be registered with UHC. Every citizen will be issued an IT-enabled National Health Entitlement Card (NHEC) that will ensure cashless transactions of services. It will also be mobile across the country and contain the individual’s health information.

How will medicines be supplied?

People will get free access to medicines. Drugs included in the published UHC package will be provided at all participating facilities and you have access to this medication under UHC coverage. The government will ensure availability of free essential medicines by increasing public spending on drug procurement and purchasing more drugs in bulk.

Where can you go to get medical care?

People will be free to choose between government hospitals as well as contracted-in private hospitals which will be part of the system. The Government will be the guarantor and enabler but not sole provider of services.

What options are there to seek additional health insurance?

Citizens are free to continue to have private insurance coverage for medical treatment not covered by UHC.

What will happen to the coverage for health insurance that I already have?

With the introduction of UHC the insurance companies will adjust their coverage to include benefits not offered by UHC. Therefore, you may continue paying for private insurance. It is your choice.

Who will deliver UHC services?

The government will invest in ensuring adequate numbers of trained healthcare providers at the different levels of care. There will thus be greater recruitment and training for the delivery of UHC services by community health workers (such as ASHAs), nurses, rural healthcare practitioners (who will be trained by the proposed 3-year Bachelor of Rural Health Care program), allopathic doctors, AYUSH workers, and allied health professionals. A trained and equipped works force will be available at both public and privately contracted in facilities.

Who will manage the system?

The government will set up new all India and state level Public Health Service Cadres and a specialized state level Health Systems Management Cadre in order to give greater attention to public health and also strengthen the management of the UHC system. The human resources will be managed by autonomous, specialized agencies for regulation, evaluation and health promotion.

How will the system be governed and made accountable?

This will be done through the National Health Regulatory and Development Authority (NHRDA) the main functions of which will be to regulate and monitor public and private health care providers, with powers of enforcement and redressal. This regulator will oversee contracts, accredit health care providers, develop ethical standards for care delivery, enforce patient‘s charter of rights and take other measures to provide UHC system support for the National Health Package so as to control entry, quality, quantity, and price. The National Authority will be linked to similar state-level institutions and to the Ombudsperson at the district level especially to handle grievance redressal.

Can the same coverage be obtained for less with private insurance companies?

It is very unlikely that you would be able to calculate a cost of your specific contributions to UHC since payment for UHC is based on a tax based system which is different from individual premiums paid for private insurance. UHC is universal and lifelong based on your status as a resident as compared to private insurance which has a limit and based on payment of premiums.