Alleviating the Scourge of Private Healthcare

In News

• 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. 

Way 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.