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Healthcare Analysis in India

  • 21 December, 2020

  • 7 Min Read

Analysis of Healthcare in India

India’s health care is a dark echo chamber.

It is 70% private and 30% public in a country where 80% people  do not  have any protection for health and the out of pocket expense is as high  as  62% (i.e Government does not bear much for public healthcare).

With public spending at 1.13% of GDP and a huge shortage of healthcare  workers particularly nurses and midwives, policy moves and plans  appear  like a sound in emptiness.

The novel coronavirus pandemic has revealed the mismatch between  the  overwhelming presence of the not so well to do and private health care with its revenue modelling that borders more on greed and rent gouging.

The fact is 85% of the population cannot afford high cost, corporate private health care.

While too little is being done too slowly to have any impact, private  hospitals gain under the social insurance scheme in the interregnum.

Even with avowedly 12 crore card holders under Ayushman Bharat, only 1.27 crore people have taken advantage of the scheme.

In health economics,where competitive equilibrium often does not exist,  the behaviour of a private corporate hospital is skewed in favour of  profitability. Any attempt to cover the non poor and the rich will result  in advantageous selection for those better-off crowding out the poor.

India’s health problem has a 80:20 rule; 20% of people can afford  modern health care, 40% cannot afford it at all and the other 40%, the so called non-poor, pay with difficulty.

Because of the problem of access, affordability, absence of quality manpower and the rent seeking behaviour of staff, more than 80%  of people routinely reach Registered Medical Practitioners who are  not trained to treat patients. But they routinely prescribe antibiotics  and steroids for quick relief.

The country could be sitting on a dormant volcano of antibiotic and  steroid immunity.

There are three options here. Ramp up the number of doctors with counterpart obligation to serve in rural areas.

Second is to revive the Licentiate Medical Practitioner as we had  before Independence in the rural areas.

The third one is to empower graduates of BSc (Nursing) to benursing practitioners .

While the primacy of primary health care is emphasised by everyone,  work on the ground does not bear it out. Admittedly, it is the critical  piece of health care but government funding is disturbingly skewed  against it.

Primary healthcare should receive three times more allocation in the  budget and doctor and paramedic strength should be doubled merely  on the basis of population increase.

But the most important thing is that States should be incentivised to carry  out the appointments of health workers and doctors.

The ratio of 0.6 nurses per doctor while the World Health Organization  specification is three nurses per doctor.

Source: TH


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