The 12th Plan may set an ambitious target of reducing the household’s out-of-pocket share from the current rate of 71 per cent to 50 per cent of the total healthcare expenditure by expanding the role of governments in ensuring healthcare.

According to the proposals under consideration by the Planning Commission for the final Plan document, the burden on the families, particularly the poor ones, would be lowered to 'tolerable levels' by reducing the household’s out-of-pocket expenditure.

“The health system for the 12th Plan should address the objectives listed above and aim to build a collaborative environment for their realization. It should prioritize the making of the system responsive to the needs of citizens, and the attainment of financial protection for the health care of households,” according to the note prepared by the Planning Commission.

It has also laid down specific targets and goals for reducing maternal mortality ratio, infant mortality rate, and total fertility rate. “At historical rate of decline, India is projected to have an MMR of 149 by 2015 and 127 by 2017. An achievement of the Millennium Development Goal (MDG) of reducing MMR to 109 by 2015 would require a further acceleration of this historical rate of decline. At this accelerated rate of decline, the country can achieve an MMR of 75 by 2017,” the note said.

India is projected to have an infant mortality rate of 38 by 2015 and 34 by 2017. An achievement of the MDG of reducing IMR to 27 by 2015 would require an even further acceleration of this historical rate of decline. If this accelerated rate is sustained, the country can achieve an IMR of 19 by 2017. India is on track for the achievement of a total fertility rate target of 2.1 by 2017, which is necessary to achieve net replacement level of unity, and realize the long cherished goal of the National Health Policy, 1983 and National Population Policy of 2000. Stagnant TFR over the last two years is, however, a matter of concern, it said.

“Underweight children are at an increased risk of mortality and morbidity. At the current rate of decline, the prevalence of underweight children is expected to be 29 per cent by 2015, and 27 per cent by 2017. An achievement of the MDG of reducing undernourished children under 3 years to 26 per cent by 2015 would require an acceleration of this historical rate of decline. If this accelerated rate is sustained, the country can achieve an under 3 child under-nutrition level of 23 per cent by 2017. This particular health outcome has a very direct bearing on the broader commitment to security of life, as do MMR, IMR, anaemia and child sex ratio,” it said.

“Prevention and reduction of burden of diseases – communicable, non-communicable (including mental illnesses) and injuries: These add to the burden of disease, reduce longevity, add to health expenditure and are very amenable to public health and preventive measures,” it said.