The world's growing riches seem to make little difference to over 100 million people globally as they slide into poverty every year because of healthcare costs. One of the unsolved conundrums in many countries is the inability to provide for universal healthcare coverage, despite economic growth and development. While the financial consequences of illness are severe for many in poorer countries that do not have appropriate systems in place, those in richer nations are by no means immune from this malady. Researchers at Harvard have made the point that illness or medical bills were behind 62 per cent of personal bankruptcies in the United States in 2007. In India, high spending on health is a major reason for people sliding into poverty. Inadequate state delivery systems mean India's private expenditure on health accounts for 72 per cent of the total health expenditure. Moreover, with poor re-financing options, a staggering 89.5 per cent of this private health expenditure is met out of pocket, from the immediately available funds of individuals. Coming up with viable financing methods, therefore, is an urgent requirement for many countries, including India. The World Health Organisation makes a timely intervention by calling for reforms in the way nations finance healthcare in its World Health Report — Health systems financing: the path to universal coverage.
Any policy that aims at reducing personal financial burden related to healthcare should focus on bringing down the direct payments by the individual. This means a change in who pays for healthcare, now borne overwhelmingly by individuals in countries that have weak government-paid healthcare systems. The question of ‘who-else-should-pay' gives itself two choices globally: integration of provision and payment, which calls for a lead role by governments; and an institutionally separate agency, say, an insurer or a government body that pays for healthcare on behalf of individuals. In India, there has been an increase in the share of private insurance to meet private health expenditure, up from 1.1 per cent in 1995 to 2.2 per cent in 2008. But this is no substitute for the state's role in providing basic, affordable healthcare. The report's suggested domestic options for innovative financing — for instance, diaspora bonds, and a minimal tax on foreign exchange transactions in currency markets (0.005 per cent in the case of India) — are timely as they could help governments fund better state-provided healthcare. Revenues raised from such measures should be used for putting in place strong and affordable delivery systems, particularly in the two important areas of primary and preventive healthcare.
I have thoroughly gone through the article and through the views of other readers. It won't be out of place to inform that the Health care system in India is perhaps not that bad as has been potrayed or understood by the readers and especially it is very economical in comparision to the Health care in West. A lot of tourists from West are comming to India only for the purpose of getting a cheaper treatment and it has been recently termed as 'Medical Tourism'. The Socialistic structure of our constitution and even otherwise the different Governments have enacted so many laws for cheap and good health care services for even the poorest of the poor and ESIC hospitals is one of such example. All state governments are making all possible meassures by managing and maintaining Government District Hospitals in each district. Further, all government medical colleges also functions as a free Hospital for all the needy. CGHS scheme for the Central Govt. employees for free medical aid is also a major socialistic act taken by the Govt. owing the responssibility. There can be no doubt whatsoever about the quality of Doctors in these institutions as they get selected after a tough and lengthy selection process on an all india basis. But, there is no doubt there is something wrong that the present system is not able to deliver the expected. The reasons are- 1. Multifold increase in population leading to larger poor and non-tax paying population, leading to lack of or limited public resources collected from limited tax payers. Further, this problem shall never get resolved because it has a political motive as this is some how related to religion and this is the segment that honestly votes. 2 In a survey it was found that the Health department was the most currupt department followed by education and Judiciary etc in India. Yes I believe this is the area where we all should concentrate and where we have a lot of opportunity to work on.
I am pained at seeing the sordid state of health care in our country where poor die without treatment. Our country boasts of being at par in terms of growth, GDP and all those numbers with the west but we havent learnt enough lessons from them when it comes to respecting human lives. I understand our problems like burden of a huge population are different from other nations but i fail to see any intent on the part of our government. We need to pool more resources and come up with more innovative ideas to make health care cheap and easily accessible to all. It may be made mandatory for doctors to serve some time in villages like few months every year or two on a rotational basis. Moreover medical programmes can be run to train health staff for common diseases after all you dont need full length courses to provide basic preventive health care. I dont know if my views are right but we have to take some ingenious steps to solve this issue.
In this regard, I would like to say that for the country like India having vast poor population, we should adopt to the policy of age old adage 'prevention is better than cure'. The state should take all the efforts to educate people how to lead a healthy life. Health awareness is the key solution to the poor people rather than treatment after illness even though both are important. For example, what is the use of spending lakhs of rupees in treating a patient infected with hepatitis-B, when it can be prevented by a simple vaccination at much cheaper price ( even though the expense is borne by the state or insurance company. After all, the government money is also the public money)? what is the use of having expensive bypass surgery or angio plasty except enriching the hospital wealth and doctors adventures when that necessity can be very well avoided by leading a better and simple life style. What the people's immediate necessity is the knowledge of holistic preventing methods and financial help from government to conduct the relevent preventive medical tests and vaccines against the deadly virussus. Of course the subsidised medical expenditure will be of great help to the poor, but after all the preventive methods. Less expensive alternative treatment methods other than the allopathy also shold be appropriately recognized by the government.
The need of the hour would be to identify and implement new ideas for raising funds for health care - taxes on mobile phone usage or levies on purchase of cars etc. Gabon has shown the way with levies on mobile phone usage. China has introduced lottery method for reducing purchase of cars and thereby solving its traffic problem. India too can levy taxes on car purchases thereby reducing its traffic woes and financing its health care.
Please allow me to share my thoughts on this important subject. While China and India, which accounts for almost 50% of the world population, have made concerted efforts in imparting the knowledge and importance of a small family norm, from the seventies, which has really made a big impact in the minds of the people, it is astonishing to note that in the poorer African countries, it is considered a taboo to talk or impose a small family norm. I have been working in an oil rich West African country for close to a decade now. I can tell you from my personal interaction with cross section of the people, that they still consider having a minimum of 3 children, because of the high mortality rate amongst infants.I really wonder, how these countries will find a balance between population and an affordable health care. Everything from housing, transportation, schooling, medicines is prohibitively costlier here. The fact of the matter is all the pharma majors are operating in these countries but still people continue to fight against the dreaded Malaria. WHO, should devote its energy and attention on finding a balance between population growth and health care in poorer countries. In the so called, developing nations like India, the growth of unorganised sector in the pharma industry needs to be checked. Interestingly, the role of the media and the advertisements through TV channels have at times proved to be counterproductive. While the intention is to advertise their product, they are unwittingly making individuals resort to self prescription. Pharmacists also play this dangerous game, in giving medicines to the gullible public, without a prescription. In your Editorial, you have talked about various financing methods. Another alternative is to have a tie up with leading health care hospitals in the country, to allow facilities for the poor and footing the bills, through appropriations in the budget. Afterall, when we can help Ambanis and Tatas make thousands of crores by giving small concessions like 2G allocation, Is it too much asking the netas for this small help?
The options you presecrbe in the editorial is viable and promising. Not only the poor, even the middle class citizens in our country can ill-afford to avail of primary and preventive healthcare, not to speak of securing specialised medicaid. Perhaps, many Indians have in their lips a prayer to the Almighty that they shall be spared of the killer diseases like cancer, heart coditions and the like. If these fatal ailments afflict them, they languish painfully helpless, soliciting death to redeem them from agony and sufferings, like a critically injured accident victims lie, in a train crash, at locations not easily accessible. The government should own up through institutional agencies the resposibility to provide for healthcare for the ordinary.
Health care in India is costly. It should be made cheaper and easily available to the poorest.
Public healthcare system has to take care of three main requirements: first, access of healthcare facilities to all those who need it; second, medical treatment at a cost which the poor can afford; third, use of all the three 'pathies' -Allopathy, Ayurveda and Homeopathy, depeding upon the patient's needs -to cure the patients. Unfortunately, there are still so many medical professionals who do not accept that the pathies that they do not practise do have some strong points and are useful to treat patients. That is how MBBS doctors are up against the Ayurveda practioners and vice versa.This should no happen.Thus there is also a case for an integrated medical education course to solve the problem of shortage of doctors in the other India, that is Bharat.Improving our healthcare systems is definitely a difficult task but I believe with the right approach, it can be sucessfully handled.
It is a known fact that 90% of the amount spent on health care has been spent from the pocket of the patients or their near relatives. The health care has also become costly. Even for small treatments like asthma a common man has to spend a five or six figure amount. Then the treatment for major ailments like by-pass surgery, and other related heart surgeries can better be imagined than described. So there is a basic and urgent need for the state to provide affordable health care to its citizens. The government should see that an aam admi gets good health care form the government at a cheaper rate.
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