The Report presents a transformative roadmap for India to achieve Universal Health Coverage (UHC) by 2047.
Systemic Challenges Identified
- Fragmented Delivery: The system is siloed into vertical disease-specific programmes and lacks coordination between primary, secondary, and tertiary care.
- Financial Hardship: Out-of-pocket expenditure (OOPE) remains a leading cause of financial hardship despite insurance schemes like Ayushman Bharat, primarily driven by the costs of outpatient care, medicines, etc.
- Quality Variations: There is a "know-do" gap where providers often fail to adhere to clinical protocols, leading to low-value care and poor health outcomes.
- Epidemiological Transition: The system faces a rising burden of non-communicable diseases (NCDs) alongside infectious diseases.
Reforms suggested by the Lancet Commission
- Empower Citizens: Strengthen local government and civil society platforms (e.g., Village Health, Sanitation, and Nutrition Committees), robust grievance redressal mechanisms, access to data on health system performance, etc.
- Public Sector Reform: Decentralized Integrated Delivery Systems (IDS), where modernized primary care networks are linked to secondary hospitals, each serving a defined population.
- Align the Private Sector with UHC Goals: Shift from fee-for-serviceto capitation and global budgets to reward value and prevention; Voluntary insurance to cover comprehensive care (outpatient + medicines).
- Other: Scale up technology (e.g. Ayushman Bharat Digital Mission); Transparent Governance (e.g. real-time data for surveillance); Connect researchers, policymakers, and providers for evidence-based refinement.
