There are four parts to the Universal Health Coverage namely, public health, primary

healthcare, secondary healthcare and Tertiary Healthcare

From the aforementioned views, let’s assess benefits and drawbacks of expanding
government health infrastructure.

Arguments in favour of expansion of government health infrastructure along

with certain negatives on insurance scheme by the government while
treatment being provided by private sector:

1. Lack of adequate public health infrastructure: India lacks the infrastructure

necessary to provide appropriate public health care. For instance, India has a total of
25650 public health centres operational in 2017. Each one was planned to serve
between 20,000 and 30,000 people. However, more than 8% of these PHCs lacked
even a single doctor, 22% lacked a single pharmacist, and so on.
2. The Large Out of Pocket Expenditure in Private Sector: Despite the fact that rural
regions house 70% of the population, secondary services are essentially non-
existent. There is a heavy reliance on the private sector, which is quite expensive,
resulting in a high out-of-pocket payment situation that may be avoided with
additional investments.
3. Staff Shortage: A shortage of physicians and other medical personnel — India's
doctor-to-patient and medical-staff-to-patient ratios are extremely low. The
relevance of this was seen in India's second wave of Covid. Therefore, it becomes
critical for the government to improve the existing infrastructure to avoid any such
further instances in future
4. Enhancing Education & Quality-of-Life: The income level of those living in villages
has to be improved. Education must be enhanced since a mother's educational level
impacts the death rate of her children. People who grow up in economically unstable
environments have a shorter life expectancy. Drainage problems, a lack of safe
drinking water, and an overcrowded atmosphere, among other things, can have
major consequences for one's health. All of these things can only be remedied if the
government invests in infrastructure and enhances the quality of life.
5. Superstitions and Myths: In India, superstitions and misconceptions regarding
illnesses and remedies are common. Access to basic primary healthcare is hampered
by misconceptions. To eliminate such problems, providing them with primary
healthcare will push them to access the facilities.
6. Disease Monitoring: This entails gathering data from a variety of sources, such as
the news media and health care providers, and then using the findings to enhance
health care services. This, however, can cause major security and privacy issues. It is
preferable to keep such data out of the hands of private players until and unless
tight and unambiguous guidelines on how the data should be treated have been
established. In the absence of this, medical data can be used to make money.

Limitations of expansion of Government health infrastructure and the positives

of providing insurance scheme:
 1. Co-operation above Competition: Private players have greater resources than public
players (higher percentage of doctors, hospital beds, better equipment etc.).
Improving the accessibility and quality of public health care requires a cooperative
rather than competitive strategy.
2. Lack of capital resources: Even if the government wanted to spend, it lacked the
necessary resources for UHC. To reach the UHC targets, a large increase (3-4 times
present levels) is necessary.
3. Insurance Packages beneficial in Tertiary Healthcare: Because specialised
consultative care and advanced medical institutions are needed in tertiary
healthcare, it will require lots of investments from the government side to develop
the infrastructure. Hence, providing insurance packages seems more relevant and
efficient here.
4. Reduction in Unplanned expenditure among masses: Unplanned health spending
places a strain on the limited financial resources available to impoverished families,
causing them to sell up their possessions in order to afford treatment, driving many
homes below the poverty line each year.
5. Increased Health Coverage: The need for health insurance coverage is increasing as
the middle class grows, as is the burden of new diseases. Many businesses provide
health insurance to their employees, resulting in increased market penetration for
insurance firms. Health insurance penetration is predicted to soar in the next years,
driven by growing demand for low-cost, high-quality healthcare.

Conclusion:
Although it may appear that the government is inefficient in administering public health, it
is just a question of time and better planning. Although collaborations with the private
sector can assist the government in bridging certain gaps, raising investments and expansion
of public health infrastructure by the government (at least for the primary and secondary
health care systems) steadily seems to address more serious issues and is the need of the
hour.