What is a positive role for gvt vis-a-vis the private sector?
One of the challenges for contracting is that at its core it involves diverting MOH resources to external agencies with a concomitant decrease in staff and authority for the ministry offices. What should be an appropriate role of government vis-a-vis private networks, and how can such a role be presented positively to ministries of health and finance? For example, how could the successes of Gujarat's Chiranjeevi Yojana initiative best be presented to other states?
Answers
In my opinion, Governments' role vis-à -vis private networks is to protect consumers and guarantee that public funding yields a social return. The existence of private networks, as opposed to dealing with isolated providers, can facilitate the implementation of a contracting mechanism that maximizes both health benefits and social equity. Provider networks in every setting need to prove to Government authorities that they have the potential to produce better quality healthcare at a lower unit cost and will reach the target population. I believe that the ministries of health and finance will be more likely to accept contracting with private networks if are the subject of an "accreditation process" that includes both technical (Quality Assurance) and financial (costing and pricing structure) criteria, among others. This can reduce the risk (and fear) of having Government’s funds subsidizing private sector's inefficiencies and/or poor quality. In summary, provider network accreditation could be one of the ways to convince Governments to use the contracting out mechanism.
Gujarat's Chiranjeevi Yojana initiative is certainly an excellent case that proves that contracting of private providers is an effective and equitable approach to health care delivery. Structured study tours made by key decision makers and leaders could be one way to present this initiative to other states. I would like to receive more information about this success story. Thanks.
