The government is planning a National Health Entitlement Card (NHEC) with the aim of providing free healthcare to all citizens. This will guarantee very Indian access to a package of essential primary, secondary, and tertiary healthcare fully funded by the central government.

The proposal has been finalized by a high-powered expert panel of the Planning Commission and it envisions covering both in-patient and OPD services free of cost with cashless facility. The health package will focus on most common and high-impact healthcare requirements.

The cost of services offered under the national health package will be borne by the Centre while the states may add-on more services and pay for them. The health services will be availed through the public sector and contracted private facilities, including NGOs.

Public or private service providers who accept the health card will not provide any services to those willing to pay additional fees from their pockets or through personal insurance policies. In this manner, people who can pay for their own health insurance will be kept out of the ambit of the health card.

In order to avail of services outside the health package, people will have to pay personally or through their insurance policy. Such services will be made available at facilities, which will not accept the health card.

Universalization of healthcare is the long-term vision of the expert group, which has suggested that public spending on health be raised from around 1.4 per cent of the GDP to at least 2.5 per cent by the end of the 12th five-year plan (2012-17), and at least to 3 per cent by 2020 to achieve the aim of healthcare for all.

According to the expert group, enhancing public expenditure by reducing private out-of-pocket expenditure will have a direct impact on the reduction of poverty.

It has also been said that the use of insurance companies to purchase healthcare on behalf of the government will not be very fruitful, and therefore, the panel suggested integrating all government-funded insurance schemes with universal healthcare and replacement of all health insurance cards by NHEC.The panel said the health ministry could take over technical and other capacities of the Rashtriya Swasthya Bima Yojana developed by the labour ministry, and this should become the core of the universal healthcare operations.

High quality primary care network, the panel said, would result in lesser need of secondary and tertiary facilities.