A new post has been so long overdue that it’s beyond the point where I can make excuses about it. I have thought of a million topics I wanted to write a post but somehow, it never happened. And then just now I watched an ad on television which said “Stop Talking. Start Doing”. So I am going to do just that :)
I am currently working on a project with a global consulting firm in India on the healthcare sector of our country. Of course I cannot divulge details of the project (confidentiality issues of a consulting firm ;)). Now, I have been doing a lot of research on this subject and believe me it is an eye opener!! Here is my take on the sorry state of our healthcare sector. (Something you won’t find in our project ;))
Background:
Healthcare sector can be divided into pharmaceutical and medical sector. The medical sector in turn comprises of public healthcare sector and private healthcare sector. Your public sector typically consists of facilities and treatments provided by your central and state government. Private providers include NGOs, not-for-profit organizations and the for-profit organizations.
The cost of treatment in a public centre is highly subsidized and free in cases of some treatments. However, for the same treatment, you could end up playing 2 to 3 times more at a private hospital and almost 20 times at a private dispensary for common non-hospitalized ailments. Therefore, it is the duty of the government to provide affordable and accessible treatment to all sections of society. Their motto, of course, being “Health for All”.
Reality Bites:
Unfortunately, the true picture is not only alarming but also depressing to a great extent. 40% of the population in our country go under heavy debt due to a single hospitalized treatment. Most of them finance the same through borrowings from friends and family. But what is more surprising is that the most affected population is not the ones who are ‘Below Poverty Line’ (BPL) but the middle class segment that is the most affected. The reasons for this being (in short without divulging into too many details):
· Preference for better medical care and service which is unavailable at a public hospital. The perils of awareness and literacy!! (There is a brilliant statement in the report for this…but damn I cant use it).
· Lack of accessibility to public providers in our country.
· Perception (which is partially true too) that private providers have better doctors.
Isn’t it ironic, don’t you think?
While analysing the reasons for the same and reading up on the healthcare sector of the other countries of the world, what was ironic was that countries like China and Cuba (with all their economic problems like India) have excellent public healthcare system. The issues of accessibility, quality and affordability have been addressed there and they have truly provided health for all. The reason I think they have been successful at this…Socialist/Communist political system in these countries. And then I wonder, is democracy a deterrent for our country?
Funds are not an issue in our country. Both the central and the state government have enough funds required to provide quality healthcare. In fact, at many a times, funds are under-utilized in India. However, what is lacking in our country are the following:
· Lack of stable political system: In our country a lot of time is wasted in waiting for approvals and bills to pass through. Then if we are lucky to get these processed fast, the actual implementation gets delayed and sometimes even halted. While the Gujarat government has been successful in reducing this bottleneck, the question arises…why cant the rest of the country?
· Lack of qualified resources: Qualified resources are a scarcity in our country (please note, the government is not even adding the clause “good”. Just “qualified”). That’s the extent to which we lack qualified doctors and nurses. Cuba provides free medical education to all medical students and over and above that binds every student to a contract where they have to necessarily serve the public sector for three years or else pay a very heavy fine. While I am not advocating free medical education (in a country where you are expected to be a doctor or an engineer, this cannot exactly be implemented ;)), the mandatory public service should be implemented honestly. In fact, the migration of doctors outside Cuba not only reduced, but today there is a surplus of doctors in Cuba.
I am currently working on a project with a global consulting firm in India on the healthcare sector of our country. Of course I cannot divulge details of the project (confidentiality issues of a consulting firm ;)). Now, I have been doing a lot of research on this subject and believe me it is an eye opener!! Here is my take on the sorry state of our healthcare sector. (Something you won’t find in our project ;))
Background:
Healthcare sector can be divided into pharmaceutical and medical sector. The medical sector in turn comprises of public healthcare sector and private healthcare sector. Your public sector typically consists of facilities and treatments provided by your central and state government. Private providers include NGOs, not-for-profit organizations and the for-profit organizations.
The cost of treatment in a public centre is highly subsidized and free in cases of some treatments. However, for the same treatment, you could end up playing 2 to 3 times more at a private hospital and almost 20 times at a private dispensary for common non-hospitalized ailments. Therefore, it is the duty of the government to provide affordable and accessible treatment to all sections of society. Their motto, of course, being “Health for All”.
Reality Bites:
Unfortunately, the true picture is not only alarming but also depressing to a great extent. 40% of the population in our country go under heavy debt due to a single hospitalized treatment. Most of them finance the same through borrowings from friends and family. But what is more surprising is that the most affected population is not the ones who are ‘Below Poverty Line’ (BPL) but the middle class segment that is the most affected. The reasons for this being (in short without divulging into too many details):
· Preference for better medical care and service which is unavailable at a public hospital. The perils of awareness and literacy!! (There is a brilliant statement in the report for this…but damn I cant use it).
· Lack of accessibility to public providers in our country.
· Perception (which is partially true too) that private providers have better doctors.
Isn’t it ironic, don’t you think?
While analysing the reasons for the same and reading up on the healthcare sector of the other countries of the world, what was ironic was that countries like China and Cuba (with all their economic problems like India) have excellent public healthcare system. The issues of accessibility, quality and affordability have been addressed there and they have truly provided health for all. The reason I think they have been successful at this…Socialist/Communist political system in these countries. And then I wonder, is democracy a deterrent for our country?
Funds are not an issue in our country. Both the central and the state government have enough funds required to provide quality healthcare. In fact, at many a times, funds are under-utilized in India. However, what is lacking in our country are the following:
· Lack of stable political system: In our country a lot of time is wasted in waiting for approvals and bills to pass through. Then if we are lucky to get these processed fast, the actual implementation gets delayed and sometimes even halted. While the Gujarat government has been successful in reducing this bottleneck, the question arises…why cant the rest of the country?
· Lack of qualified resources: Qualified resources are a scarcity in our country (please note, the government is not even adding the clause “good”. Just “qualified”). That’s the extent to which we lack qualified doctors and nurses. Cuba provides free medical education to all medical students and over and above that binds every student to a contract where they have to necessarily serve the public sector for three years or else pay a very heavy fine. While I am not advocating free medical education (in a country where you are expected to be a doctor or an engineer, this cannot exactly be implemented ;)), the mandatory public service should be implemented honestly. In fact, the migration of doctors outside Cuba not only reduced, but today there is a surplus of doctors in Cuba.
· Bribery and “working around the system”: Neha said something today to me that at the point seemed very funny but it’s so true. In India, if you need to get anything done, just be prepared to “shell out money and give it below the table…that’s it. Your work will be done!”. So this very easily gets you out of the compulsory public service.
China, Cuba and other developing and emerging countries are faced with situations very similar to India. Wide socio-income divides, poverty, illiteracy etc. But because of their communist and socialist outlook, they have implemented policies and no questions asked. No opposition parties, no unions. They “Stopped Talking and Started doing”.
There have been successful initiatives in India in Tamil Nadu, Delhi and North east India. However, they have all been isolated initiatives and have failed in other parts of the country. There seems to be a lack of will on part of the state government and sometimes, a certain degree of helplessness. China has been the fastest growing developing nation in the world and as far as healthcare is concerned, it’s definitely not “Third World”. Cuba is a very high Human Development Index (comparable to developed nations) as far as healthcare is concerned.
While I am not advocating socialism or communism, I wonder that in a country as diverse as us with diverse economic and cultural disparity, would such a system have worked better. Would such a system address issues of disparity and inequitable distribution of resources? Would it truly provide “health for all”?
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