Question : COSTLY TREATMENT

(a) whether the Government has taken note of untimely death and pitiable conditions of the patients of economically weaker sections who are not able to afford the high cost of treatment;

(b) if so, the details thereof and the reaction of the Government thereto;

(c) whether the Government has also taken note that high cost of treatment/ spending major part of their income on medical bills is taking a heavy physical, mental as well as financial toll on the people of the country and if so, the reaction of the Government thereto;

(d) whether the Government proposes to fix rates of various treatments being charged by private hospitals in the country, if so, the details thereof and if not, the reasons therefor; and

(e) the remedial measures including providing affordable/free treatment to the people from the economically weaker sections of the society, taken/proposed to be taken by the Government to bring down the overall cost of treatment in the country?

THE MINISTER OF HEAL TH AND FAMILY WELFARE (SHRI JAGAT PRAKASH NADDA)

(a) & (b): Public Health is a state subject and hence the primary responsibility to provide healthcare to the entire population including the economically weaker sections lie with the States/UT Governments. Under the National Health Mission (NHM), support is provided to States/UTs to strengthen their healthcare delivery systems to provide equitable, accessible, affordable and quality health care with locus on addressing health needs of the poor and vulnerable groups based on the requirements projected by the States in their Programme Implementation Plans.

(c): The Government is aware of the high Out of pocket expenditure on healthcare. Public health being a state subject, under NHM the central government has been supplementing the efforts of the State/UTs to provide affordable health care facilities to all section of the population. Further, under the Rastriya Swasthya Bima Yojana Further, (RSBY) cashless benefit for certain secondary care hospitalisation procedures upto Rs. 30,000 per annum per family is available to all BPL population and certain other vulnerable population groups. Under the Rashtriya Arogya Nidhi (RAN) financial assistance is granted to Below Poverty Line patients suffering from major life threatening diseases.

(d): Public Health being a state subject, matters of regulation of the private healthcare sector also lie within the domain of the State Governments. The Government of India has already enacted the Clinical Establishments (Registration and Regulation) Act, 2010 and notified Clinical Establishments (Central Government) Rules, 2012 for registration and regulation of the Clinical Establishments. It is upto the State Governments to appropriately adopt and implement the same.

(e): Public Health being a State subject, under NHM the following services are expected to be provided free of cost to all citizens who access these services in public health facilities:

# Maternal and Reproductive Health sendees,

# The Universal Immunization Programme (UIP) that provides immunization against 7 vaccine preventable diseases and free TT vaccination,

# Pulse Polio Immunization [PPI],

# Family Planning supplies and services,

# Child Health services that include both Home Based and facility based New bom Care,

# Communicable diseases services:

v Investigation and treatment for Malaria, Kala azar, Filaria, Dengue, JE and Chikungunya,

v Detection and treatment for Tuberculosis including MDR-TB,

v Detection and treatment for Leprosy,

v Detection, treatment and counseling for HIV/AIDs.

# Non Communicable diseases services:

v Cataract surgery for Blindness control- over 6 million free cataract surgeries done every year,

v Cornea transplant,

v Glaucoma/ Diabetic Retinopathy,

Besides above, under the national initiative of “Janani Shishu Suraksha Karyakram” (JSSK), every pregnant woman is entitled to free delivery, including caesarean section, in public health institutions. The entitlements includes free drugs and consumables, free diagnostics, free diet, free blood wherever required, free transport from home to institution, between facilities in case of a referral and drop back home. Similar entitlements are in place for sick infants up to one year of age and cases of ante natal and post natal complications as well.

Under the national initiative of Rashtriya Bal Swasthya Karyakram (RBSK), support is being provided to States/UTs for Child Health Screening and Early Intervention Services through early detection and early management of common health conditions classified into 4 Ds i.e Defects at birth, Diseases, Deficiencies, Development delays including disability. Certain treatments including; surgeries at tertiary level is free of cost under this initiative.

Under the National Ambulance Services (NAS), support under NHM is provided to States for patient transport particularly the pregnant women (for delivery), sick infants and patients needing trauma care. NHM is also providing funding to States/UTs to provide free essential drugs and free essential diagnostics in public health facilities under the NHM - Free Drugs Service and NHM - Free Diagnostic Service Initiatives respectively.