The dialogue was the first in the series of NITI Aayog’s “Development Dialogues” that aims to facilitate multisectoral conversations on India’s developmental issues, which constitute a part of the country’s 15 Year Vision document. [caption id=attachment_3716 align=aligncenter width=799] Union Minister for Road Transport and Highways, Shipping and Water Resources, River Development and Ganga Rejuvenation, Shri Nitin Gadkari addressing Mumbai 2.0 Conference organised by Project Mumbai & Govt. of Maharashtra in Mumbai[/caption] Participants in dialog The inaugural session was chaired by Dr Vinod Paul, Member, NITI Aayog and included the participation of Shri Amitabh Kant, CEO, NITI Aayog, MsPreeti Sudan, Secretary, Ministry of Health and Family Welfare and Shri Alok Kumar, Adviser, NITI Aayog. Dr. SuwitWibulpolprasert, Global Health Advisor, Government of Thailand gave the keynote address detailing Thailand’s four-decade journey towards Universal Health Coverage. Need for convergence in Health sector “This dialogue is a sign that Health has taken center-stage of the policy narrative. We must move towards breaking silos between various stakeholders in the health space, remove fragmentation between various initiatives, and ensure convergence between various ministries and also between Centre and States. POSHAN Abhiyan and Ayushman Bharat can be an innovative model to view integrated health systems”, said Dr Rajiv Kumar, Vice-Chairman, NITI Aayog, addressing the closing plenary of the dialogue. Strengthening and further building on the existing blocks for Health Systems The dialogue focused on strengthening and further building on the existing blocks for Health Systems for a New India and prioritized four critical health systems issues for discussion and debate. These included expanding resources for health through pooling existing funds; expanding the role of the government as a strategic purchaser from both public and private providers to improve quality of healthcare services; provision of equitable and integrated services; and leveraging technology as an enabler and aggregator. The dialogue also deliberated convergence of fragmented building blocks of financing and service provision, with each reinforcing the other, and moving from programmatic or schematic approaches to a systemsapproach to healthcare. Ayushman Bharat is a good opportunity The roll-out of the ambitious Ayushman Bharat was also hailed as a good opportunity to bring in systems thinking and de-fragmenting the various building blocks of healthcare systematically over time. Further, strengthening governance, policy and regulatory frameworks and institutions were deemed key to ensuring systemic transformation of the health sector for a new India. Healthcare insurance There was broad consensus that the development of a health system for India can lead to the growth of a healthy and globally competitive healthcare insurance and health service provision industry and more importantly, improved consumer experience and citizen trust in the healthcare system. Dr Paul emphasized that trust in the system will be key for building an efficient health system for a new India, which is inclusive, integrative and indigenous. Emergency Manager thinks that health insurance is essential for improving healthcare system in India.However,precaution should be taken that health insurance costs does not bind the hands of emergency managers and poor citizens are driven out. As Mr Kant stated in the inaugural plenary, it is time to bring the patient to the centre of the health care narrative and the time has come to evolve a world-class health system which is transformative and uniquely Indian. It is estimated that if the required decisions in terms of creating a functioning Health system are taken, then it shall reduce adult deaths by up to 16% by 2030, thereby increasing economic growth up to 32%. Reduction in healthcare cost It is also estimated that breaking programmatic silos and integration of various schemes within a systems approach will lead to reduction in avoidable out-of-pocket expenses to about 45%of total health spending by 2030, preventing at least 1.5 millionadditional households to go below the poverty line due to illness and unaffordable health care. The discussions were guided by analysis undertaken by well-known international experts from multilateral organisations, along with over 25 national and international experts from over six countries and 150 participants representing government, private sector, insurance companies, third party administrators, research and academia. The analysis and insights highlight that investments in strengthening and building on the current mixed health system will reap social and economic dividend for India.