What are the challenges faced by government in achieving its objective of "Universal Health Care"in the country? Discuss some of the steps taken by the government in the recent years to achieve this ambitious target.

The out of pocket expenditure has resulted in debt trap for large number of Indians. The panacea for this menace is the universal health care. The government is not able to achieve its objective of Universal health care. The challenges include:

• Size of Population: India’s large size population and the quantum of expenditure the universal health care demands make it a mammoth task.
• Economy: Indian economy is driven by unorganised sector. The large chunk of population is dependent on small household industries or agriculture. It limits the outreach in effective structuring of Universal health care.
• Medical Infrastructure: The twin handicapped structure of human resource and physical infrastructure limits the 3As (Availability, Affordability and Accessibility) of health care.
• Awareness: Lack of awareness about the need of insurance has resulted in lack of penetration of efforts of the government.
• Regional disparities: The disparities between States and between rural and urban areas within the State make the task of universal health coverage an uphill task.
• Gaps in the Scheme: The rigidness of the Schemes like Rashtriya Swasthya Bhima Yojana makes it unattractive and unviable as the coverage was capped at low levels which were at below par levels of health expenditure incurred.

Steps taken by government

• Ayushman Bharat- National health protection scheme: The government aims to provide the universal health care through the Ayushman Bharath scheme. The scheme provides an insurance cover for about 10 lakh families with insurance cover of 5 lakh per family.
• National Health Policy 2017: National health policy 2017 provides for a target based approach by establishing targets to achieve under IMR, MMR etc. The policy envisages a mechanism of collaborative approach through involvement of private sector to accomplish the objectives of the National health policy.
• Replacing MCI with National medical commission: The inability of the MCI in terms of both quality and quantity has led to crisis of human resource in the medical sector. In order to address both issues of quality and quantity government has proposed setting up of National Medical commission.
• Pradhan Mantri Swasthya Suraksha Yojana: To address the regional imbalances in the healthcare government has proposed setting up of AIIMS in the backward regions to address the issues of regional disparities.
• Pradhan Mantri Matritva Sahyog Yojana: To address the issues of maternal and neonatal health care the scheme of Pradhan Mantri sahyog Yojana has been launched.

The huge size and diversity of India poses a serious challenge in ensuring of universal health care. The steps taken needs to be expedited to increase the pace of implementation by effectively engaging with the state governments and private sector.