The Foundation for Democratic Reforms (FDR) in association with the Public Health Foundation of India organized a National Roundtable on Universal Healthcare at the India International Centre, Delhi, on the 23rd April, 2016. The event engaged eminent policy makers, health professionals and economists. Starting with a brief presentation of the proposed healthcare model, the suggested reforms aimed to establish a more accessible, efficient, and high-quality healthcare system by focusing on three central features: strengthening primary care with family physicians, expanding and integrating secondary care through private partnerships, and ensuring efficient tertiary care via referral-based systems in district and teaching hospitals. 

The major recommendations and point of consensus at the roundtable spanned over primary, secondary and tertiary care. Overview of the proposed models at each of the levels are as follows:

• At the primary care level, the focus remains on ensuring that every individual or family has access to a designated family physician as the first point of contact for all health concerns. Family physicians play a crucial role in providing personalized, preventive, and continuous care, acting as the gatekeepers for the healthcare system. They address minor ailments, manage chronic diseases, and guide patients on when to seek higher-level care. This approach reduces the burden on secondary and tertiary care facilities and makes healthcare more cost-effective.
• The secondary care level proposes expanding the Rashtriya Swasthya Suraksha Yojana (RSSY) by integrating small private nursing homes into the healthcare network. Contracting these facilities allows patients to access a wider range of services closer to their homes. This public-private partnership model leverages the existing infrastructure and expertise of the private sector, expanding healthcare capacity without significant capital investment. 
• At the tertiary care level, district and teaching hospitals will focus on delivering specialized and complex care, accessible only through referrals from primary or secondary care providers. This ensures that tertiary care resources are reserved for cases that truly require advanced treatment, such as cancer care, organ transplants, and other high-complexity interventions. Teaching hospitals will serve as centers of excellence, combining patient care with medical education and research. District hospitals will be upgraded to act as regional hubs, equipped with advanced infrastructure and specialist teams. By implementing a referral system, tertiary facilities can reduce overcrowding and focus on their core purpose, while patients benefit from a streamlined continuum of care. Digital health platforms will facilitate efficient referral management and record-sharing between healthcare providers.

Each level was designed to enhance patient care by emphasizing choice, competition, and integration across the healthcare continuum. Feedback from the Roundtable was taken and a modified presentation was made to the NITI Aayog on 25th April, 2016.