The Problem of Public Health Care

According to the report of commission on Macroeconomics and Health (CMH) established by WHO, macroeconomic effects of investment in health of the people are tremendously high. The health care system of Pakistan is not delivering particularly for the poor. This claim is based, inter alia, on WHO data for the LMICs on access to health services, World Bank time series data on life expectancy, and household survey data of Pakistan Bureau of Statistics. WHO data shows that the poor of Pakistan are at the bottom in terms of coverage and access to health care compared to the poor of other low-middle-income countries. The World Bank time series data of life expectancy for the South Asian region and other comparator countries indicates that Pakistan has shown slow progress against this variable in comparison to selected countries. Similarly, data of the household surveys, etc., confirms glaring inequities in access to health in terms of location, gender, and SES. The low priority given at the national level to health is also vindicated by the low per capita spending on health. Undernutrition is discussed as one of the daunting challenges. Role of women agencies is emphasized for better health care and capital formation. Some simple solutions like the establishment of village community dispensaries and connecting them to big hospitals, prioritizing preventive and primary health care, and introducing generic drugs are presented besides analyzing Sehat Sahulat Card System. Right to health is recommended to be recognized as a fundamental right enforceable by the courts of law as health meets the touchstone to be qualified as a pure public good. It is non-rivalrous, non-excludable, and has got positive externalities.