We
are a country of 1.25 billion plus population out of which approx 88cr are living
in the rural areas & urbanization has touched a mere 37cr people. Unlike
western countries we have a huge gap between both the settlement. Even though it
would be inaccurate, if we presume all these urban citizen lives a very good
life. In a lower middle income country like ours, Cities are also having challenges
of their own, in many cases people are even deprived from the basic amenities
like food, shelter, health & hygiene.
Being
part of relatively educated mass, It's always quite captivating, when I read,
we are the 7th largest economy (in terms of nominal GDP) & our GDP growth
will surpass china soon. I don't understand whether these figures are compelling enough to give a smile in the face
of that poor man who resides in the remotest corner of our country with sub 1$ income.
Out
of all the essential indicator, healthcare is pivotal. We are the 3rd largest
pharmaceutical market in terms of volume & 14th largest in terms of value. India
is known for its cost-effective medical tourism & home to highly skilled medical
professionals. Despite all these clamour
we are 112 in the WHO ranking for healthcare system globally. This evident
because one million Indians die
every year due to inadequate healthcare facilities and close to 700 million
people have no access to specialist care.
Inadequate
Healthcare Budget :
The
Indian Govt spends 2.27 % of GDP on healthcare where as it's approx 8-9% for developed
countries.India’s healthcare spending is the lowest among BRICS (Brazil,
Russia, India, China, South Africa) nations,. Even neighbouring countries like Pakistan(2.6%),
Srilanka (3.5%) spends more on healthcare.
Govt. Infrastructure:
The problem essentially lies with government hospitals and their
poor infrastructure. While there are many universal health care schemes being
run by the Central and the State Governments in India and the government
hospitals offer treatment and essential drugs free of charge, the fact that the
government sector is understaffed, underfinanced and that these hospitals
maintain very poor standards of hygiene forces many people to visit private
medical practitioners and hospitals.
Niti Ayog Report of 2015,
based on a survey, showed that around 41% of anganwadis have inadequate
space, 71% are not visited by doctors, 31% have no nutritional supplementation
for malnourished children and 52% have bad hygienic conditions.
Insurance Penetration:
While the insurance penetration is quite high in most of the
developed nation , In India’s healthcare industry lack of a medically insured
population and have high no's of patients who spend out-of-pocket (about 71 per
cent of the total health care expenditure in the country was borne by households ).
Shortage of
HCP:
Our doctor-patient population ratio of 1:1,674,
worse than Vietnam, Algeria and Pakistan. India is falling short of 500000
doctors.
Public-health centres across India’s rural
areas–25,308 in 29 states and seven union territories–are short of more than
3,000 doctors, the scarcity rising 200% (or tripling) over 10 years.
Lowest Bed/ Patient
ratio:
India
has only 1.1 beds per 1,000 population compared to the world average of 2.7 bed
per 1,000 . 70% of India’s healthcare
infrastructure concentrated in the top 20 cities. Hence there is a huge opportunities need
to be uncover in the Indian healthcare Industry. Corporate India is already
sharing a huge patient load due to lack
of infra from the govt. side . There should be certain alternative need to be
developed to bridge the gap in healthcare segment.
Suggestions:
Priority
Sector Tag:
Healthcare
should be given a priority sector tag (currently, agriculture, MSMEs, export
credit, education, housing, social infrastructure, renewable energy and others
have been given this status) .This will help channelize funds from the banking
sector to create necessary healthcare infrastructure
Development
of healthcare specific PPPs:
Tax incentive, low interest, import duty wave off
& Scaling up PPPs in the healthcare sector will require. Effort to
standardise concession agreements and collateral and exit clauses. Private
sector should be encourage to establish more centres in tier 2 -3 cities with
viable economic models.
Health
care fund :
A fund similar to the provident fund should be introduced
for salaried employees .It could be also used to pay for outpatient services
and preventive health checks .Investments into this fund could be tax
deductible under section.
Foreign
Investment:
The healthcare sector has been benefited with a good
no of green & brown field projects over last couple of years. The govt should
encourage more on this & also huge incentive should also be given for
setting up health care facility in tier 2-3 cities.
Mandatory
Rural Posting:
Mandatory rural posting for at least 5-10 years should be imposed on
healthcare providers. It could also be linked with their appraisal. However it
would be unfair if the govt will be doing same without creating basic
infrastructures ( Housing/ Electricity/ Quality education for their kids/
Transportation).
Though the govt initiatives like
Pradhanmantri Swastya suraksha Yojna, Universal health cover are few good
initiative in this direction but we need to take more
time bound & result oriented initiative to reduce pain of burgeoning patient population of our country.
