Alleviating the Scourge of Private Healthcare
- In India, private healthcare needs to be made affordable alongside expanding public healthcare.
Key Indicators for Indian Health Sector
- Poor Ranking: India ranks poorly on multiple health financing indicators.
- Meagre Public Health Expenditure: Its public health expenditure as a percentage of its GDP (1.28%) and share of general government expenditure dedicated to health (4.8%) remain akin to the poorest countries.
- Lower Per capita health spending: Per capita, health spending growth has not kept pace with rising incomes.
- Higher out-of-pocket Expenditure: Higher Private spending still constitutes nearly 60% of overall expenditure on health.
Issues with Indian Health Sector
- Dispersed Private Sector: The private sector in India is inexorably dispersed, with significant inequities between rural and urban areas and widespread market failure.
- Disproportionate Burden of Insurance Schemes on the Private Sector: Public health insurance schemes impose unreasonable package rates on empanelled private providers with weak regard for actual costs of care. This deters the active participation of the private sector.
- Lack of Infrastructure: India has been struggling with deficient infrastructure in the form of a lack of well-equipped medical institutes and less-than-adequate human resources.
- Shortage of Manpower: Shortage of efficient and trained manpower and the situation remains worrisome in rural areas.
- Lack of specific competencies: It is common for heads of health services at national, state or district levels in India to be orthopaedic or cardiac surgeons or ophthalmologists who have no training in public health.
- Huge Patient Load: Even prior to the outbreak of the Covid-19 pandemic, healthcare facilities had been feeling the strain due to unmanageable patient load.
Looking Ahead
- Addressing Imbalances:
- The setting up of new facilities will have to address imbalances at three levels- Regional, specialities, and ratio of medical doctors to nurses and other healthcare professionals.
- The existing scenario suggests that public healthcare service should ensure three “Es- Expand – Equity - Excellence”.
- There is a need to increase government spending to reduce personal spending.
- Affordable Private Healthcare:
- Initiatives need to be taken that seeks to make private healthcare more affordable without affecting care quality. Moreover, such policies must be enshrined in India’s national health policy.
- Expansion of Tertiary Care:
- Access to adequate health care would need the expansion of tertiary care facilities.
- Tertiary care should be equitably distributed to different segments of the population.
- Family Health Teams (FHT):
- Like in Brazil, India needs Family Health Teams (FHT) accountable for the health and well-being of a dedicated population.
- The FHTs must consist of a doctor with a diploma in family medicine and a dozen trained personnel.
- Quality Medical Education:
- The expansion in the next five-year plan must be systematic whose contours must be based on infusing quality in the future medical education and care.
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