Expert Group on Universal Health for India held Session to Address World Bank’s Concerns

The High Level Expert Group on Universal Health Coverage for India held a session on 27 November 2011 to address concerns raised by the World Bank over some of the recommendations in the group’s report for the 12th Five Year Plan. The issues raised during the session centred around marginalisation of the private sector and the elimination of intermediation by insurance companies.

The expert group that emphasised on the need to strike a balance between cost-effectiveness, affordability in terms of budget and equity, remained committed to providing universal health coverage to al. The focus of the group was on cost-effective primary care, especially guaranteeing access to free medicines to generate appreciable health, economic and political benefits in the short timeframe.

Apart from the commitment to provide equity and coverage in health care at the primary and district level, the group’s report also recommended the setting up a separate group that would look into the possibilities of providing tertiary care as well.

World Bank’s Views on the Expert Group’s Report

According to theWorld Bank, the expert group’s report lacked an analysis of the private sector, a dominant financier and provider of health services in India. It complained that the report marginalised the role of the private sector in this repect.

The World Bank diaagreed with the report's recommendation to eliminate intermediation by insurance companies or other independent purchasing agencies as experiences showed that intermediaries had contributed substantial administrative and technical capacity to the government agencies. It mentioned that large investment in health worker training did not guarantee greater supply of human resource in the public sector and much of the subsidy was likely to be captured by individuals.

Contradicting the group’s view, the organisation also felt that India's universal health coverage strategy would be much more successful in delivering health, economic and political benefits, if it could focus on achieving results at the primary and district level rather than improving access to expensive tertiary care.

The expert group needed to be pragmatic, and develop structure relations with private providers carefully.