Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Heath is clearly not the mere absence of disease. Good Health confers on a person’s freedom from illness and the ability to realize one’s potential. Health is therefore best understood as the indispensable basis for defining a person’s sense of wellbeing.
The health of population is a distinct key issue in public policy discourse in every mature society often determining the growth of society at large. They include its cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care. and current bio-medical understanding about health and illness. Health care covers not merely medical care but also all aspects of 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. Where, as in India, private healthcare out-of-pocket expenditure dominates the cost financing health care, the effects are bound to be regressive.
Heath 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.To set right these gaps demanded patient redefinition of the healthcare sector role keeping the focus on equity. But during the last decade there has been an abrupt switch to market-based governance styles and much influential advocacy to reduce the state role in health in order to enforce overall compression of public expenditure to reduce fiscal deficits.
People have therefore been forced to switch between weak and efficient public services and expensive private provision or at the limit forego care entirely except in life threatening situations, in such cases sliding into indebtedness. Health status of any population is not only the record of mortality and its morbidity profile but also a record of its resilience based on mutual solidarity and indigenous traditions of self-care — assets normally invisible to the planner and the professional. Such resilience can be enriched with the State retaining a strategic directional role for the good health of all its citizens in accordance with the constitutional mandate. Within such a framework alone can the private sector be engaged as an additional instrument or a partner for achieving shared public health outcomes. Similarly, in indigenous health systems must be promoted to the extent possible to become another credible delivery mechanism in which people have faith and are encourage qualified doctors in rural areas to get skills upgraded.
Public programs in rural and poor urban areas engaging indigenous practitioners and community volunteers can prevent much seasonal and communicable disease using low-cost traditional knowledge and based on the balance between food, exercise medicine and moderate living. Such an overall vision of the public role of the heterogenous private sector must confirm the course of future of state led health care in the country.