Health care is one of the significant sectors for achieving overall human development in the country.  The delivery of health care in most of the countries involves some form of public–private partnership. In many countries, the care will be delivered through the public system but many inputs like support services and pharmaceuticals will be sourced from the private sector. There exist two types of organizations, one is for-profit which operates hospitals as one business among many and the other is not-for-profit which aims only at healthcare. To achieve the aim of the universal health care, the Indian healthcare sector requires new model of public–private partnership.

A health services PPP means a long-term contract between one or more private sector companies and a public sector authority. The government has to set up goals for an optimal health system, provide thestrength of its purchasing power, and authorize private sector to develop or manage service delivery over the term of the contract. The opportunity for multi-sector market participants involves technology companies, hospital providers and physician groups, private health insurers, pharmaceutical and medical device companies, facilities managers and construction firms. Some of the PPP projects have proceeded smoothly while others have been highly controversial. The public-private partnerships in India have been extremely successful in developing infrastructure.

Issues in the health sector of India

In the health sector, comprehensive privatization is not possible due to the market failure. There exist many constraints in the health sector of India. A few of them are lack human resources and investment, hopeless management of present infrastructure, accessibility and coverage in rural areas, etc. A reformation in the health care is required. For this, both the public and private sectors has to work together. The prepaid private insurance coverage for poor and the commercial capital investments in healthcare delivery play an important role in the reformation. There are mainly two categories of insurances in India - Life and General. The health insurance is usually covered under the general insurance category. Some of the general insurance companies are Oriental Insurance Co. Ltd., National Insurance Co. Ltd., New India Assurance Co. Ltd., United India Insurance Co. Ltd etc. A few health insurance specialist companies in the private sector are Royal Sundaram Alliance Insurance. Co. Ltd., Tata AIG General Insurance Co. Ltd., Reliance General Insurance Co. Ltd., Birla Sun Life Insurance Co. Ltd., Bajaj Allianz General Insurance Co. Ltd., etc.

It is a fact that the Confederation of Indian Industry (CII) had so far been targeting at metros or urban mass only. The industry should get support of the government to look at PPP models in balancing the roles of the private and public sector without affecting the cost. In the present budget, a portion has been allocated for the prosperity of health sector. Now, it is the turn for the industry to come up with new developmental ideas to eliminate the issues like infrastructural deficiencies, manpower shortages, concerns related to quality and cost of services.

Initiatives for the development of health care sector

The last summit has decided to set up a Healthcare Sector Skills Council. The memorandum of understanding between the CII and the National Skills Development Corporation has been signed in that event. The main objective of the council is to meet the severe shortage of qualified personnel by accessing to universal access healthcare services.  The Council has set a striving target of assisting 4.8 million personnel in the coming 10 years. This is really an ambitious target and so the council definitely needs the help of government to meet this deficit. The government must come up with a clear regulatory outline on the terms and conditions for setting up new medical colleges.

The other issues faced by the sector in the present situation are affordability, quality, workforce, and accessibility.  The government has extended many benefits to the industry for getting more trained manpower. The quality of services in the major cities was of high standard whereas it is not happening in the case of Tier 2 and Tier 3 cities. The growth in the industry depends on increased awareness, appropriate development of the PPP model, and increased awareness. The existing health care system is not working for all. So, there is a need of new mutual mechanisms between the private and public sector. Nowadays, public’s views about healthcare had changed from seeing it as a sign of affluence to one of privilege. Hence, the time has reached for the industry to give more emphasis on enhancing innovative healthcare delivery systems that include access and costs, equity, both of drugs and treatment procedures.

Since the discussion points to health and urban-rural division, there might have disproportions among various states. According to the report submitted by the high-level expert group on health, the need of the hour was to get a guarantee from the government for the healthcare for all. The introduction of card scheme may benefit this system. The government can use a justifiable portion of its direct revenue for the healthcare developments. All existing central schemes have to be clubbed together under an India health card scheme. For more effective service delivery, a central regulatory body has to be created for the health sector.

The healthcare industry needs care from other sectors also. Developments in other sectors should care about the concerns of the healthcare industry.  The healthcare industry has the power to become the largest employment creator. The government has to reconsider the imposition of service tax on the industry. This has driven up the cost of treatment for the underprivileged and the poor. Recently, some organizations like IFC showed interest to invest in Tier 2 and Tier 3 cities. The major concern for them was quality in the health facilities available in these areas. It offers advice on services and technology that such institutions must deliver for enough outside investments. The healthcare industry would get a boost only if the public, private and civil society sectors enhance a suitable strategy. Only providing the right device with the right manpower would help in servicing the Tier 2 and Tier 3 cities and towns. We can hope that the council launched by the CII and the NSDC would help in making quality healthcare accessible to all.