ABSTRACT
Healthcare is one of the key pillars of any democratic society; the other two being education and the environment. Government is duty bound to ensure the well-being of the population through frameworks of governance built around these pillars. Health reforms are characterized by four elements: accessibility, availability, affordability, and safety. Quality in healthcare and patient safety are two faces of the same coin. Quality is generally driven by market forces (that is, by way of open competition). However, when supply is limited, as compared to demand, quality takes the back seat. Healthcare in India is at this stage. Healthcare is expected to be regulated, as it affects the well-being of the common person, but with the Government short of resources, and dependent on the private sector, the enforcement of regulation has become difficult. Today, when the private sector has about an 80 percent share in healthcare expenditure, Government is highly reliant on the private sector to provide healthcare, even for its own welfare schemes. In such circumstances the key way to promote quality is to drive change through payers, and at the same time, empower the community to demand quality. This chapter highlights key aspects of India’s journey and current status in this area of healthcare reform.
