Vision for India’s Health System
Citizen-Centred Health System Vision for India: The Lancet Commission Report presents a long-term roadmap for building a citizen-centred health system in India. Its core goal is achieving Universal Health Coverage (UHC) by 2047, aligning with India’s 100-year Independence milestone.
The report shifts focus from hospital-centric care to people-first health systems. It treats citizens not as beneficiaries, but as active participants in healthcare governance and delivery.
Static GK fact: India’s health governance follows a federal structure, where health is primarily a State subject under the Seventh Schedule of the Constitution.
Structural Problems in the Health System
India’s health delivery system remains fragmented and siloed. Vertical disease programmes operate separately, weakening coordination between primary, secondary, and tertiary care levels.
This fragmentation leads to duplication, inefficiency, and poor patient continuity. Referral systems remain weak, especially in rural and semi-urban regions.
Static GK Tip: The primary healthcare model in India is based on the Alma-Ata Declaration (1978) principle of “Health for All”.
Financial Burden on Citizens
Out-of-Pocket Expenditure (OOPE) continues to be a major cause of financial distress. This persists despite insurance schemes like Ayushman Bharat.
The main drivers are outpatient care costs, medicine expenses, diagnostics, and follow-up treatments. Insurance protection remains skewed towards hospitalization rather than everyday healthcare needs.
This creates a treatment-access gap, where affordability determines survival outcomes.
Quality and Care Delivery Gap
The report identifies a serious “know-do gap” in healthcare delivery. Clinical knowledge exists, but protocol adherence remains weak at the ground level.
This results in low-value care, misdiagnosis, irrational drug use, and poor health outcomes. Standard treatment guidelines often fail to translate into actual practice.
Changing Disease Burden
India faces a major epidemiological transition. The system must manage non-communicable diseases (NCDs) alongside infectious diseases.
Conditions like diabetes, cardiovascular diseases, cancer, and mental health disorders are rising rapidly. At the same time, communicable diseases remain persistent in vulnerable populations.
Static GK fact: India is currently in the third stage of demographic transition, marked by declining mortality and fertility with rising chronic diseases.
Citizen Empowerment Reforms
The report emphasizes citizen empowerment as the foundation of reform. It promotes stronger local government institutions and community platforms.
Structures like Village Health, Sanitation, and Nutrition Committees (VHSNCs) are identified as key grassroots governance tools. Citizens must have access to health system performance data and grievance redressal mechanisms.
This builds social accountability and trust in public health systems.
Public Sector Transformation
The Commission proposes Decentralised Integrated Delivery Systems (IDS). Modernised primary care networks should be linked to secondary hospitals.
Each network should serve a defined population with continuity of care. This creates a population-based health planning model instead of disease-based silos.
Private Sector Alignment
Private healthcare must align with UHC goals. The report suggests moving from fee-for-service models to capitation and global budgets. This rewards prevention, value-based care, and long-term outcomes. Voluntary insurance should cover comprehensive care, including outpatient services and medicines.
Technology and Governance
The report supports scaling digital health infrastructure through the Ayushman Bharat Digital Mission. It stresses real-time surveillance systems, transparent governance, and integrated data platforms.
It also promotes stronger linkages between researchers, policymakers, and healthcare providers for evidence-based reforms.
Static Usthadian Current Affairs Table
Citizen-Centred Health System Vision for India:
| Topic | Detail |
| Report Name | Lancet Commission Report |
| Core Goal | Universal Health Coverage by 2047 |
| Key Focus | Citizen-centred health system |
| Structural Issue | Fragmented health delivery |
| Financial Problem | High out-of-pocket expenditure |
| Disease Pattern | Dual burden of NCDs and infectious diseases |
| Governance Reform | Citizen participation and transparency |
| Delivery Model | Integrated Delivery Systems |
| Digital Support | Ayushman Bharat Digital Mission |
| Policy Direction | Prevention-based, value-driven healthcare |
