Session 10 | Quality healthcare for all —pipedream or reality?

 Panelists:

Dr. Gurpreet Singh Wander - Chief Cardiologist, Hero DMC Heart Institute
Dr. Ashok Seth - Chairman, Fortis Escorts Heart Institute & Cardiology Council
Prof. Gerard George - Director (Rajiv Gandhi Center), Imperial College, London
Dr. Naresh Trehan - Chairman & Managing Director, Medanta

 Moderator:

Ms. Shruti Mishra - Producer & Anchor, CNBC TV18

As India aims to become a global power, the country has to lay particular focus on the health and well-being of its citizens. However, the healthcare system in the country has to go a long way to reach the global standards.

Compared with other countries in the world, the healthcare system in India shows a dismal performance on almost all parameters ― be it access, affordability, quality or capacity. In India, the estimated number of beds per 10,000 people is 9, compared with the global average of 30. Further, the country has only 7 lakh doctors to serve a population of 1.2 billion; and if one considers the specialists available, the number is even lower. Moreover, urban areas, with a population of only 30 percent of the country, account for about 67 percent of the healthcare infrastructure. This has led to an acute supply shortage to sub-urban and rural areas, which account for about 70 percent of the country’s population.

Another detrimental factor is healthcare expenditure. The government spends only 1.1 percent of the country’s gross domestic product (of a total USD1.1 trillion) on public healthcare, and an additional 3.7 percent is privately financed. Consequently, 75 percent of healthcare expenditure is borne by the people. This makes the country one of world’s largest consumer-focussed healthcare markets. Further, healthcare insurance penetration rate in India is one of the lowest in the world, comparable to some of the underdeveloped countries such as Nigeria, the Dominican Republic and Bangladesh. Owing to low public spending and poor insurance penetration rate, people in these countries have to spend a lot more on healthcare than their counterparts in developed nations. The dismal performance of public healthcare system has led to the growth of the private healthcare system in India. Today, the majority of the Indian population prefers to seek private healthcare facilities.

Responding to the need of the hour, the Planning Commission of India, in early 2012, drafted a proposal on the lines of the ‘managed care system’ followed in the US, wherein the role of the government is diluted from that of a provider to a manager. This proposal aims at streamlining the healthcare system to help the patient become the prime benefactor. This will likely help the government efficiently deal with major healthcare issues and achieve the ultimate goal of universal health coverage (UHC). According to the proposal, private players will need to service patients at the lowest possible costs agreed upon with the government. Further, service providers are expected to be reimbursed for each medical prescription.

The proposal is seen as a step toward revolutionising the Indian healthcare system by adopting various best practices prevalent in the US. However, it has expectedly created ripples in various relevant stakeholder circles. Although, with this proposal, the government has taken a step toward developing the healthcare system in the country, it has a long road to travel. It is still not clear whether we  will be successful in expanding hospitals beyond cities, building speciality facilities, increasing the penetration of medical insurance and leveraging technology to come up with innovative healthcare solutions or will quality healthcare always remain a distant dream in India.