Microsoft co-founder Bill Gates said on Thursday that India should aim to double its spending on healthcare from the present levels of 1.3% of GDP, and tap the insurance market and private sector health providers to create safety covers for the vulnerable while competing on costs.
“The United States spends about 18% of GDP on health, and no one else comes close. The basic architecture for healthcare should have vaccines and pregnancies in the public health system that have quality spending and doubles your spending from 1.3% of GDP that it is today,” Mr. Gates said, speaking at an event by the Bill and Melinda Gates Foundation, of which he is a trustee, and the Observer Research Foundation.
Public sector
“For non-communicable diseases, the public sector is not the best approach. The best approach is that the government somehow causes the insurance market to get critical mass and include private service providers who compete on their costs of providing those services. The biggest role has got to come from the private providers,” Mr. Gates said.
Recalling the first project the Foundation worked on in India, he said that the focus was on ensuring the AIDS epidemic didn’t turn into large numbers like Thailand and some parts of Africa.
“So our primary focus was that commercial sex workers didn’t get infected as much, so as to create a general epidemic. Our tactic was to create communities of workers that talk to each other to insist on safe practice by creating a critical mass. The benefits were larger as they talked about exploitation and getting out of that line of work,” he pointed out.
Principal Economic Advisor in the Finance Ministry Sanjeev Sanyal said the most important ingredient for better health is actually better drains than hospitals.
“In India, this is a serious issue. Public health is held down first and foremost from sanitation. This is reflected in the rise of mosquitoes and communicable diseases and so on. I think while people discuss vaccines which are very important, I do think it’s important to remember that basic municipal services are an extremely important part of improving the quality of life and health,” he said.
Citing estimates that that 2/3rds of the benefits to public health since the industrial revolution have come from better drains rather than hospitals, he said: “…Mr. Gates may not want to get involved in our municipal governance issues, but I do want to remind everybody else that is got to place that we need to work the hardest.”
