1. Create a national health mission
“Throw out the term National ‘Rural’ Health Mission,” says Bali, pointing out that it shows the segmented approach to health care planning in the country. Others suggest the creation of a National Health Fund, resources for which can be generated from various indirect and direct tax measures.
2. Tax junk food
Make it impossible for the food and beverages industry to sell products that are nutritionally poor and loaded with calories, says New Delhi-based nutritionist Ishi Khosla, who advocates a “tobacco tax” on unhealthy food. Incidentally, several nutrition advocacy groups and even bodies such as the World Health Organization have been suggesting that nations should introduce a “Fat Tax” or a tax on junk food in order to encourage people to make healthy choices. They cite research that shows how prohibitive taxes on tobacco and alcohol have significantly curbed consumption of these items.
The revenue from taxes on junk food can be used to fund health education programmes just as some countries use tobacco taxes to fund anti-tobacco programmes.
The revenue can be pretty sizeable. A Yale scientist, Kelly D. Brownell, showed how a tax of 1% on a 12-ounce soft drink in the US would generate $1.5 billion (Rs6,000 crore) annually, and a national tax of 1% pound of candy, chips and other snack foods would generate revenues of up to $314 million.
3. Incentivize wellness programmes
Dr Pervez Ahmed, executive director, Max Healthcare, New Delhi, suggests giving incentives for wellness programmes. This, again, has been a subject of much deliberation, with various consulting firms working out the cost benefit analysis of investing in wellness programmes at the workplace and pointing out the positive gains. The government could incentivize such programmes by providing tax benefits to employers who have well-defined wellness policies and implement health measures at the workplace. Extending it further, incentives could also be given to schools that have a nutrition education programme, encourage sports and provide healthy food in cafeterias.
4. Set up a disease surveillance mechanism
Recognizing that diseases can ruin countries, there have been several proposals for setting up a special body for disease surveillance in India, on the lines of the US-based Centers for Disease Control and Prevention, which monitors and checks the prevalence of communicable, non-communicable and pollution-related diseases. The Indian Council for Medical Research does have an Integrated Disease Surveillance Programme, but experts feel it is largely research-based. A separate authority on disease surveillance could work out timely strategies to tackle diseases and epidemics.
5. Create a strong third party insurance mechanism
Currently, according to government estimates, only 10% of Indians have health insurance coverage. The easiest way to realize the dream of providing health care facilities to all is through the insurance route, say experts. “The life insurance sector is in effervescent mode now. We need to see a similar energy in the health insurance sector,” says Bali. He suggests awareness programmes to boost the health insurance sector, doubling tax rebates for subscribing to insurance, and other policy moves to ensure wider coverage.
At the same time, community health insurance schemes, such as the ones piloted by Self Employed Women’s Association (SEWA) in Ahmedabad, Narayana Hrudayalaya in Bangalore and Karuna Trust in Karnataka, could bring health care closer to the needy.
6. Farm policies to promote healthy eating
Take a lead from the European Union, which is looking into the connection between agriculture and health of nations. At regional EU meets, bodies such as FAO (Food and Agriculture Organisation) and WHO are debating whether promoting the production of healthier crops like fruits and vegetables could help reduce obesity. Other health proactive farm ways could include measures to reduce the use of toxic pesticides that are thought to cause cancers and give incentives to organic food manufacturers which would bring down prices of healthier, alternative foods.