The Road To Health For All: Financing, Regulation, And The Justiciable Right To Care In India
- IJLLR Journal
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Akhila S T, Department of Law, University of Kerala
I. Introduction
Universal health coverage rests on a deceptively simple promise: that every person, wherever they live and however much they earn, can obtain the health services they need — preventive, curative, rehabilitative, and palliative — without being ruined by the cost of care. The philosophy of UHC rests on the proposition that health is a fundamental human right, a principle traceable to the 1948 Universal Declaration of Human Rights and operationalized by the 1978 Alma-Ata Declaration, which made primary health care the cornerstone of global health efforts. It acquired formal legal and political weight through the 2012 United Nations General Assembly resolution urging nations to prioritize health-care access for all. It became a binding global development target with the adoption of Sustainable Development Goal 3.8 in 2015, which calls for universal access to essential health services without financial hardship.
India's predicament is that of a rising economic power with a lagging health system. Out-of- pocket payments account for a strikingly large share of total health expenditure, one of the highest proportions in the world, and the cost of care is a considerable driver of poverty. The question this article addresses is therefore not whether India should pursue UHC, but why UHC is an inescapable daily necessity for Indian households, how the legal and regulatory architecture can be rebuilt to attain it, and when, by what milestones, attainment can realistically be achieved. Part II defines the concept. Part III explains the necessity of UHC in ordinary, day-to-day life. Part IV examines the constitutional and statutory foundations of the right to health. Part V analyzes the instruments of attainment, with particular attention to financing, insurance, and regulation. Part VI addresses the chronology of reform.
II. Universal Health Coverage: Concept and Content
The World Health Organization's conception of UHC, ensuring that all individuals and communities receive the necessary, high-quality health services without financial hardship, spans a wide spectrum of care: preventive measures, treatment of illness and injury, rehabilitation, and palliative care. Three structural features distinguish UHC from ordinary health insurance. First, it is universal: coverage extends to the entire population regardless of socioeconomic status, geographic location, or personal circumstances. Second, it is comprehensive: it reaches beyond hospitalization to the outpatient and primary-care services that people use every day. Third, it is protective: its cardinal objective is the elimination of financial barriers that force households into poverty or cause them to forgo treatment altogether.
