Health Policy Issues and Health Programmes in ... - Amazon S3

Public–Private Interaction in Health: Policy Issuesthey do not follow standard procedures and cause harm to patients by providing inadequatequality of service. In India, the introduction of the Consumer Protection Act acknowledged therights of consumers. In addition, “paid for medical services” were brought under the Act. Patientscan now take matters to consumer councils (judiciary bodies of about 500 persons established toprovide speedy and cost-effective justice) for their grievances and inadequate quality of services.Do governments pay adequate attention to educate consumers? The consumer movement andadvocacy groups are in their infancies and have a long way to go in order to emerge as forces thatensure healthy practices from the private sector.Regulatory Mechanisms: Implementation ChallengeEffective regulatory mechanisms to regulate various aspects of private health care provision arelacking. There cannot be a single piece of legislation that can tackle all problems. Each stateneeds a set of effective regulatory mechanisms ensuring that systems behave properly.Experiences across Indian states suggest that there is no systematic development of regulatorymechanisms. Implementation of whatever regulations have been promulgated has always beena problem, and implementation and enforcement of rules and regulations (wherever theseregulations have been adopted) is weak because of the following.l With health being a subject for the state in India, response to different legislation has variedfrom state to state.l There has been a considerable amount of resistance from various constituents of the privatehealth care sector (particularly private providers) to accept, in principle, the applicability ofcertain regulation to their profession.l Response of the medical profession to develop rules, norms, and various mechanisms forself-regulation has been poor.l Many pieces of regulation have not changed with the times and, therefore, have lost theirrelevance in the present-day context.l Private sector issues are not high on the public policy agenda; this, however, is changing fast.102There are many developments on the regulation side that strengthen the functioning of the privatehealth care market. Nevertheless, much needs to be done on the regulation side. Thesedevelopments are in the area of providing more powers to consumers and discouraging someinappropriate practices, such as sex determination, organ trading, and privatization of insurance.l Consumer Protection Act 1986 The Supreme Court of India passed a judgment that theConsumer Protection Act is applicable to “paid for medical services.”l Other Recent Legislative Changes Two important pieces of legislation were passed that willdiscourage certain practices.n Human Organ Transplant Act, 1995n Pre-Natal Diagnostic Techniques (Regulation and Prevention of Misuse) Act, 1996l Privatization of Insurance Under the new economic policy reforms, the government has nowliberalized the insurance sector.Private Participation Initiatives in HealthPrivate participation initiatives in health can be broadly classified into initiatives on the demand side(primarily focusing on financing of health care) and the supply side (provision of health services).