Good Health means freedom from illness. Health is therefore best understood as the indispensable basis for defining a person’s sense of well being. The health of populations is a distinct key issue in public policy discourse in every mature society including India. They include the country’s cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care.
Health care covers not merely medical care but also all aspects pro preventive care too. Nor can it be limited to care rendered by or financed out of public expenditure within the government sector alone but must include incentives and disincentives for self care and care paid for by private citizens to get over ill health.
Whereas in India, private out-of-pocket expenditure dominates the cost financing health care, the effects are bound to be regressive. Health care at its essential core is widely recognized to be a public good. Its demand and supply cannot therefore, be left to be regulated solely by the invisible hand of the market. Nor can it be established on considerations of utility maximizing conduct alone.
What makes for a just health care system even as an ideal? Four criteria could be suggested- First universal access, and access to an adequate level, and access without excessive burden. Second fair distribution of financial costs for access and fair distribution of burden in rationing care and capacity and a constant search for improvement to a more just system. Third training providers for competence empathy and accountability, pursuit of quality care and cost effective use of the results of relevant research. Lastly, special attention to vulnerable groups such as children, women, disabled and the aged.
It has to be admitted that the growth of public health in India has been very slow due to low public expenditure on health, very few public health institutes in India and inadequate national standards for public health education. However recent years have seen efforts towards strengthening public health in India in the form of launch of National Rural Health Mission (NRHM) and initiation of more public health courses in some medical colleges. Still there is a long way to go.
There is an urgent need to promote, indigenous health systems promoted to the extent possible to become another credible delivery mechanism in which people have faith. Public programs in rural and poor urban areas engaging indigenous practitioners and community volunteers can prevent much seasonal and communicable diseases using low cost traditional knowledge and based on the balance between food, exercise medicine and moderate living.
The current issue of Safety Messenger is reaching your hands with some important features and articles on public health. The idea is to generate serious public discussions on this vital subject so as to help the emergence of a more inclusive, responsible, equitable and affordable quality public healthcare system in the country.