Has the Government failed on our healthcare?

Gunarjun Chawla

“No individual should fail to secure adequate medical care because of inability to pay for it” was mentioned by the Bhore Committee,1946 at the start of its preamble. 

The committee set up in 1943 by the Government of India was tasked with surveying the existing position regarding the health conditions and structure in the country. The report presented by the committee emphasized the integration of curative and preventive medicine at all levels and a complete revamp of the health service. 

Since Independence, there has been a significant push in the health status of people but the situation has not improved much. As per the Lancet study published in 2018, India ranked 145 in 2016 in the global healthcare access and quality (HAQ) index marginally gaining from its previous rank of 153 in 1990. Despite improvements in healthcare access and quality, India lagged way behind its BRICS peers Brazil, Russia, China, and South Africa on the HAQ index.

While India’s scramble to create more beds was evident during the start of COVID 19, It may not come as a surprise that only 12 countries fared worse than India when it came to bed availability. India has just five beds for 10,000 Indians. The Human Development Report 2020 showed that out of 167 countries, India ranked 155th on bed availability and 131 on the overall Human Development Index ranking out of 189 nations measured. 

“The government has failed us” is a popular narrative that is generally echoed for these states of affairs in the country. However, it’s important to sport the role of devil’s hat before blaming the government for the current predicament. 

Where does India stand?

Public hospitals account for only approximately 10% of the total number of hospitals throughout the country. The remaining are operated almost entirely by the private for-profit sector and a meagre number by charitable organizations. People prefer private hospitals for advanced medical treatment, clean and hygienic rooms, better nursing, and allied services over state-run healthcare. Another critical factor that has favored the booming privatization of healthcare is the facilities a patient gets which varies from the type of bed, food quality, treatment and even selecting of a doctor. When it comes to affordability, about 60% of India’s nearly 1.3 billion people live on less than $3.10 a day, the World Bank’s median poverty line. And 21%, or more than 250 million people, survive on less than $2 a day.

It’s also important to note that the private health expenses in industrial countries now average only some 25 percent because of universal health coverage (except in the United States, where it is 56%), in India, families typically pay 80 percent of their health care costs as “out-of-pocket” expenses when they receive health care.

Lack of adequate coverage by the prevailing public health care system in India means that many Indians turn to private healthcare providers. This is an option generally inaccessible to the poor. To help pay for healthcare costs, insurance is available, often provided by employers, but most Indians lack personal health insurance, and out-of-pocket costs make up a large portion of the spending on medical treatment in India.

Where should a common citizen go then?

Two key areas of concern for a common person in India, when it comes to healthcare, are the cost of treatment and the out-of-pocket expense associated with medicine procurement. For the magnitude of India’s size and density, it is imperative to have the full backing of the policymakers to make any tangible shift towards progress and growth. In recent years, the government has tried focusing on addressing these areas by bringing transformative policies catering to this domain: 

One such governance program was the flagship Ayushman Bharat, which encompasses the National Health Protection Scheme (Pradhan Mantri Jan Arogya Yojana – PMJAY) covering tertiary care for vulnerable populations and Health and Wellness Centres initiatives for the delivery of comprehensive and integrated primary care. 

And second, being an innovative cost-containment mechanism by setting up Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP) to increase the supply of generic pharmaceuticals and normalize medical expenses. 

To give a better understanding of the scope and outreach of these policies, A detailed analysis has been carried as mentioned below:

Figure 1: Policies Analysis 

Figure 2: Heatmap

Will these reach the citizens?

Mahatma Gandhi’s words “It is health which is real wealth, and not pieces of gold and silver” were implied symbolically in these COVID times. The pandemic highlighted the domino effect of health care on several other verticals paving way for some innovative restructuring and self-realization. 

The recent commitment by the central government to increase the public healthcare spending as a % of GDP, from the existing 1.15% to 2.5% by 2025 and the proposal in the latest budget FY 2021-22 to double India’s health-care and wellbeing spending to Rs 2,23,846 crore (an increase of 137% from the last budget) is a clear intention to give more impetus to healthcare. With such initiatives targeting the welfare of the masses, the intent is set. However, the age-old question remains “Will this benefit pass on to the common people or be lost in bureaucracy?”.

heaGunarjun Chawla is an MBA student from Cranfield University, UK. He has previously worked in KPMG in the risk consulting department. He is a serial entrepreneur having worked as director/co-founder in three ventures so far. He can be reached at gunarjun.chawla@cranfield.ac.uk or via LinkedIn www.linkedin.com/in/gunarjun-chawla. 

Views are personal and may not necessarily reflect those of Qrius and/or its staff

Has the Government failed on our healthcare?