India's UHC strategy rests on a continuum of care from primary to tertiary level. Critically examine its financial-protection and digital components.

Universal Health Coverage means access to care without financial hardship. India's model, presented at UNGA81, links over 1.8 lakh Ayushman Arogya Mandirs by referral to secondary and tertiary care, with financial protection and digital tracking as the two connecting rails [1]. Both rails have delivered measurably, yet both are built around episodic hospital care rather than lifelong disease management.

Financial protection: real gains, narrow coverage

• AB-PMJAY, the Free Drugs and Diagnostics Service Initiative and the PM National Dialysis Programme form the affordability leg [1].
• Outcomes are demonstrable: out-of-pocket expenditure fell from 62.6% to 39.4% of total health spending by 2021-22, while the government share rose to 48% [2].
• Critique: a falling national average can still conceal households pushed into poverty by a single illness. Assurance schemes are designed around hospital admission, whereas hepatitis B needs lifelong antivirals and sickle cell disease lifelong follow-up — recurring outpatient costs that sit outside the package.

Digital health: reach without proof of outcome

• Over 900 million health IDs, ABHA-linked records, interoperable registries, and 497 million e-Sanjeevani teleconsultations with AI-enabled X-rays compress distance [1].
• Critique: digitisation records activity, not cure. Against 1.80 lakh hepatitis screening points stand only 1,039 treatment centres [1] — a linkage-to-care gap, not a data gap. Globally only 3% of hepatitis B patients were on treatment by end-2022 against an 80% target for 2030, and India is among ten countries carrying two-thirds of the burden [3]. Similarly, 7.29 crore SCD screenings yielded only 4.93 crore Sickle Cell Cards [1].

The continuum is strongest at entry and weakest at retention. The next reform step is to measure UHC by treatment continuation and catastrophic expenditure, not screening counts — extending outpatient cover to chronic conditions and matching every screening point with an accessible treatment centre. India's low generic drug prices [4] make this affordable, turning a strong delivery architecture into demonstrable health outcomes consistent with SDG-3.