A report by a health commission set up by the United Democratic Front (UDF) in the run-up to the Assembly elections to look into the state’s public health system suggested a comprehensive overhaul of existing health insurance and financing policies. They argue that these reforms would directly reduce out-of-pocket health spending.
The commission, headed by SS Lal and consisting of members who held extensive consultations with public health experts across the state, recommended the establishment of a comprehensive universal health system.
This scheme would cover all eligible citizens, both above and below the poverty line, and would ensure that the current ‘missing middle’ – families excluded from the Karunya Arogya Suraksha Padhati (KASP) who cannot afford private health insurance – are not left without health care protection. The report notes that this is necessary to prevent catastrophic health care spending from pushing middle-class families into debt and destitution.
The proposal calls for the expansion of universal and effective insurance coverage by strengthening and integrating publicly funded insurance systems. It recommends automatic enrollment of all eligible households, including a ‘missing middle’, simplified benefit packages and truly cashless treatment.
The report states that the current KASP health insurance system, despite its broad coverage, is in disarray due to significant arrears owed by the government to public and private hospitals and pharmaceutical firms for claiming reimbursements and payments for drugs, diagnostics and equipment.
It emphasizes the need to stabilize the financing of health insurance by improving the sustainability of publicly funded systems. This can be achieved by settling claims in a timely manner, budgeting realistically in line with utilization levels, and avoiding the accumulation of arrears that undermine provider participation.
Patients who seek care in public hospitals are entitled to free medicines and diagnostics. The report suggests allocating a dedicated budget for drugs, laboratory diagnostics, surgical consumables and accessories for government hospitals to ensure that patients are not forced to purchase these items elsewhere while receiving care.
The report also recommends strategic reforms in facility-level resource mobilization by hospital development committees. It proposes specific guidelines to increase transparency and accountability in the use of resources, thereby improving the delivery of health services.
The Commission further proposes to strengthen financial oversight and expenditure monitoring by enabling the Public Finance Management System (PFMS) to monitor health expenditure at facility, district and state levels. This would help detect delays, leakages and underutilization at an early stage and ensure that funds are used as intended.
Another key recommendation is the implementation of a unified health information system that assigns a unique health identification number (UHID) to all citizens and integrates patient records, laboratories, pharmacies and diagnostic services across all public facilities to ensure continuity of care across referral levels.
The report highlights the need to ensure interoperability of digital platforms to share real-time data across programs, facilities and levels of care to support outbreak monitoring, planning and preparedness. It also recommends implementing care coordination systems to ensure continuity of care at different hospital levels, supported by the latest software solutions.
Finally, the commission pledged to investigate deficiencies in Medisep, the health insurance system for civil servants and pensioners. It recommends securing a financial contribution from the government to the system in order to improve accountability and strengthen its functioning.
Published – 12 Feb 2026 20:05 IST