https://www.un.

org/sustainabledevelopment/health/

Goal 3: Ensure healthy lives and promote well-

being for all at all ages
Ensuring healthy lives and promoting the well-being at all ages is essential to sustainable
development.

GOAL 3 TARGETS BY 2030:

Strengthen the capacity of all countries, in particular developing countries, for early warning, risk
reduction and management of national and global health risks.

Substantially increase health financing and the recruitment, development, training and retention
of the health workforce in developing countries, especially in least developed countries and small
island developing States.

Support the research and development of vaccines and medicines for the communicable and
non communicable diseases that primarily affect developing countries, provide access to
affordable essential medicines and vaccines, in accordance with the Doha Declaration on the
TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the
full the provisions in the Agreement on Trade Related Aspects of Intellectual Property Rights
regarding flexibilities to protect public health, and, in particular, provide access to medicines for
all.

Strengthen the implementation of the World Health Organization Framework Convention on

Tobacco Control in all countries, as appropriate.

By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and
air, water and soil pollution and contamination.

Achieve universal health coverage, including financial risk protection, access to quality essential
health-care services and access to safe, effective, quality and affordable essential medicines and
vaccines for all.

By 2030, ensure universal access to sexual and reproductive health-care services, including for
family planning, information and education, and the integration of reproductive health into
national strategies and programmes.

By 2020, halve the number of global deaths and injuries from road traffic accidents.

By 2030, reduce by one third premature mortality from non-communicable diseases through
prevention and treatment and promote mental health and well-being.

By 2030, end preventable deaths of newborns and children under 5 years of age, with all
countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and
under-5 mortality to at least as low as 25 per 1,000 live births.

By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births.
HEALTH BUDGET:

States can play an important role in building necessary capacities and co-
funding of schemes, particularly the National Health Mission

Health care spending in India has remained at an all-time low — around 1.3 per cent
of the Gross Domestic Product (GDP) — in comparison to other countries such as
Thailand and Vietnam that spend close to three per cent of their GDP. The problem
of low public health spending isn’t new and has been discussed for a long time. It is
also a fact that the issue cannot be solved with a blink of an eye. Yet, people talk
about it when Budget season nears and remain critical of the Government’s
allocation for this sector. This year’s interim Budget wasn’t an exception. Health
allocations were increased to nearly Rs 63,300 crore from Rs 54,600 crore in 2018-
19 — an increase of 16 per cent. This is a decent raise. In fact, this is the highest
rate in comparison to the last three interim budgets: 10.7 per cent in 2004-05, 3.8 per
cent in 2009-10 and 0.7 per cent in 2014-15. For those unfamiliar, the Central health
budget consists of two types of allocations: Central schemes and establishments that
account for nearly 40 per cent of the health budget and various Centrally-sponsored
schemes that account for 60 per cent. Unlike Central schemes that are financed
totally by the Centre, Centrally-sponsored schemes are co-funded by the Centre and
States but are implemented by the States. In the interim budget, allocations to
Central schemes and establishments were raised by 12 per cent; while those to
Centrally-sponsored schemes were raised by 19 per cent .

Those criticising the health budget are not much critical of the overall increase, which
of course, is a perennial issue but about the perceived misallocation across
Centrally-sponsored schemes. To elaborate: Of the two Centrally-sponsored
schemes — the National Health Mission (NHM) and the National Health Insurance
Scheme (PMJAY) — the budget for the former was increased by only 5.4 per cent
while the latter saw an increase of 228 per cent. A significantly smaller increase in
NHM budget, much of which goes towards the strengthening of primary care and a
huge increase in PMJAY allocation, is being criticised. This is being interpreted as
prioritisation of health insurance over primary health care. But this isn’t a fair
interpretation. Why? First, in absolute terms, NHM allocations are way above PMJAY
allocations. Second, the health insurance scheme is expected to move faster than
the strengthening of primary care given the supply of hospital care, both in the public
and private sector, and the pent-up demand for such care. On the other hand,
primary health care, regardless of the priority it deserves, is slow-moving as supply
side needs fixing. This will take some time. Until that happens, the health insurance
scheme will continue to receive higher incremental allocations than NHM.

The current challenge with primary health care is that it is getting redesigned and,
therefore, new capacities have to be built. So, from the health financing perspective,
there is a thin band or an interval between too little allocation and too much
allocation. While a generous allocation to primary health care may result in un-
utilisation of funds, a somewhat reduced allocation may result in shortage of funds.
The fact that allocation to primary health care is closely tied to the issue of capacity
creation, appropriate allocations fall within a narrow band. However, the perceived
misallocation in health is likely to correct itself over the next few years as supply of
primary health care strengthens and the share of public health funding in GDP rises.
As per the National Health Policy 2017, the Government is committed to raising the
share of public health spending to 2.5 per cent of the GDP by 2025. Further, the
Government is committed to spending up to two-third or more of this on the primary
healthcare. Achievement of these targets is linked to the overall economic
performance and its impact on Government revenues. Also, it’s important to note
that States fund two-third of the total Government health spending. So, the health
spending goal cannot be achieved without a signification step-up of funding by the
States.

Those, who have been following the health budget for the last few years, must have
noticed a break from the culture of higher budget allocations. For example, in the last
three years, the budget utilisation rate has been over 100 per cent: 106 per cent, 102
per cent and 109 per cent in 2015-16, 2016-17 and 2017-18 respectively. This
means that additional allocations were made during mid-year revision of budgets.
Contrast this with the budget utilisation rate of 85 per cent, 81 per cent and 81 per
cent in 2011-12, 2012-13 and 2013-14 respectively. This suggests that initial budget
allocations are indicative that it can be revised upward, if needed. The need is also
to discuss issues of outputs and outcomes too.

To sum up, health allocations in this year’s budget were decent by standards of an
interim budget. States have an important role to play both in building necessary
capacities and co-funding of schemes, particularly NHM. It is important to get this
perspective right in understanding the Central health budget.
The demand for healthcare services in India is expected to grow exponentially; however, the
country’s public expenditure on health (by the Union and State governments combined) has
remained at a low level of around 1 percent of GDP over the last two decades. The deficient level
of public spending on health has resulted in poor infrastructure and inadequate human resources
in this crucial sector. This has adversely affected both the coverage and quality of healthcare
services available in the country, especially to the large proportion of economically weaker
sections of the population. Nearly 70 percent of healthcare services in India are being provided
by the private sector; this, along with lack of access to generic medicines, is believed to have
increased the out of pocket expenditure by people on healthcare.
Given the widely acknowledged need for stepping up the country’s public expenditure on health,
CBGA’s research pays special attention to the budgetary priorities for the sector both at the level
of Union Government as also the States. There is a strong emphasis on generating evidence
around three core issues in the health sector – the adequacy of overall public spending on the
sector, access to free generic medicines in government healthcare facilities, and availability of
human resources for public provisioning of healthcare. However, there is also a need for better
utilisation of the available budgetary resources in the sector since poor financial management
and a top-down approach in planning and implementation of programmes have posed major
challenges. Accordingly, we also examine the patterns of fund utilisation in some of the important
government programmes for health sector like, the National Health Mission.
Presently, CBGA is also collaborating with civil society budget groups and health rights groups
across a number of States for analysing the policies, budgets and implementation challenges
pertaining to health sector.

Consumer Protection Act in Healthcare

Regulating the private health care sector: the case of the Indian Consumer
Protection Act. Author information: ... The recent decision to bring
private medicalpractice under the Consumer Protection Act (COPRA) 1986 is
considered an important step towards regulating the private medical sector.
Consumer rights and protections
The Affordable Care Act (ACA) came into effect on September 23, 2010. It included certain rights
and protections for consumers.These rights and protections help make health care coverage
more fair and easy to understand.

These rights must be provided by insurance plans in the Health Insurance Marketplace as well
as most other types of health insurance.

Certain rights may not be covered by some health plans, such as grandfathered health plans. A
grandfathered plan is an individual health insurance policy purchased on or before March 23,
2010.

Always check your health plan benefits to be sure what type of coverage you have.

Information
RIGHTS AND PROTECTIONS
Here are ways that the health care law protects consumers.

You must be covered, even if you have a pre-existing condition.

 No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for
any condition you had before your coverage started.

 Once you're enrolled, the plan can't deny you coverage or raise your rates based only on your health.

 Medicaid and the Children's Health Insurance Program (CHIP) also can't refuse to cover you or
charge you more because of your pre-existing condition.

You have a right to receive free preventive care.

 Health plans must cover certain types of care to adults and children without charging you a
copayment or coinsurance.

 Preventive care includes blood pressure screening, colorectal screening, immunizations, and other
types of preventive care.

 This care must be provided by a doctor who participates with your health plan.

You have a right to stay on your parent's health plan if you are under 26 years old.
Generally, you can join a parent's plan and stay on until you turn 26, even if you:

 Get married

 Have or adopt a child

 Start or leave school

 Live in or out of your parent's home

 Aren't claimed as a tax dependent

 Turn down an offer of job-based coverage

Insurance companies can't limit yearly or lifetime coverage of essential benefits.

Under this right, insurance companies can't set a limit on the money spent on essential
benefits the entire time you are enrolled in the plan.

Essential health benefits are 10 types of services that health insurance plans must cover.
Some plans cover more services, others may vary a bit by state. Check your health plan
benefits to see what your plan covers.

Essential health benefits include:

 Outpatient care

 Emergency services

 Hospitalization

 Pregnancy, maternity and newborn care

 Mental health and substance use disorder services

 Prescriptions drugs

 Rehabilitative services and devices

 Management of chronic disease

 Laboratory services

 Preventive care

 Disease management

 Dental and vision care for children (adult vision and dental care are not included)

You have the right to receive easy-to-understand information about your health
benefits.
Insurance companies must provide:

 A short Summary of Benefits and Coverage (SBC) written in easy-to-understand language

 A glossary of terms used in medical care and health coverage

You can use this information to more easily compare plans.

You are protected from unreasonable insurance rate increases.

These rights are protected through Rate Review and the 80/20 rule.

Rate Review means that an insurance company must publicly explain any rate increase of
10% or more before increasing your premium.

The 80/20 rule requires insurance companies to spend at least 80% of the money they take in
from premiums on health care costs and quality improvement. If the company fails to do so,
you may get a rebate from the company. This applies to all health insurance plans, even those
that are grandfathered

You can't be denied coverage because you made a mistake on your application.
This applies to simple clerical mistakes or leaving off information not needed for coverage.
Coverage can be cancelled in the case of fraud or unpaid or late premiums.

You have the right to choose a primary care provider (PCP) from the health plan
network.
You don't need a referral from your PCP to receive care from an obstetrician/gynecologist.
You also don't have to pay more to receive emergency care outside of your plan's network.

You are protected against employer retaliation.

Your employer cannot fire you or retaliate against you:

 If you receive a premium tax credit from buying a marketplace health plan
 If you report violations against Affordable Care Act reforms

You have the right to appeal a health insurance company decision.

If your health plan denies or ends coverage, you have a right to know why and to appeal that
decision. Health plans must tell you how you can appeal their decisions. If a situation is
urgent, your plan must deal with it in a timely manner.

ADDITIONAL RIGHTS
Health plans in the Health Insurance Marketplace and most employer health plans must also
provide:

 Breastfeeding equipment and counseling to pregnant and nursing women

 Contraceptive methods and counseling (exceptions are made for religious employers and non-profit
religious organizations)