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THE COST OF HEALTH

SYLLABUS:

• GS 3: Indian Economy and issues relating to planning, mobilization, of resources, growth, development and employment.
• Inclusive growth and issues arising from it.

Focus:

• Capping costs in private sector is important but healthcare can’t do without adequate state investment.

Healthcare Costs and Impoverishment

• Healthcare expenses can quickly become overwhelming, leading to financial crises for families.
• Out-of-pocket costs can cause impoverishment, making it one of the most severe societal issues.
• High healthcare costs fuel resentment and occasionally violence against healthcare workers.
• The Supreme Court of India has addressed the need for regulation on healthcare pricing.
• Families often reach out to doctors in desperation to mitigate these expenses.

Supreme Court’s Intervention

• The Supreme Court considered imposing CGHS rates on all hospitals as a temporary measure.
• This action was in response to a PIL that requested the regulation of hospital charges nationwide.
• The court’s potential involvement raises questions about its effectiveness in an area where previous government actions have faltered.
• Resistance is expected from the healthcare industry and influential doctors.
• The court’s move is a significant but small step towards making healthcare affordable.

Publicly Funded Healthcare Systems

• A publicly funded health system is essential for providing timely and effective care free of charge.
• Universal healthcare systems ensure no one pays at the point of care, funded by taxpayer money.
• The intention is for the wealthy to subsidize the health costs of the poor.
• Effective public healthcare was an initial goal post-Independence in India.
• However, underfunding and neglect have allowed private sectors to thrive, undermining public healthcare.

Challenges with Private Healthcare in India

• Healthcare inherently involves unpredictability and empathy, not easily managed by market rules.
• India’s healthcare sector remains one of the least regulated worldwide.
• There is significant co-option in the medical profession, with doctors owning hospitals and profiting from unnecessary treatments.
• Private hospitals offer high-tech and efficient care, attracting the middle class and even the economically disadvantaged.
• This leads to a problematic mix of excessive private care costs and suboptimal state care.

Importance of Private Care Providers and Start-ups in India’s Healthcare System:

• Penetration: Private medical sector serves as the primary source of healthcare for the majority of households in both urban (70%) and rural areas (63%), making it crucial for improving healthcare accessibility and efficiency.
• Poor Public Healthcare: With low quality and long waiting times in public hospitals, people seek better healthcare services, where the private sector can excel, especially if costs remain affordable.
• Affordability: Despite being a rapidly growing sector, fragmentation makes it challenging for patients to find affordable healthcare. Start-ups in digital healthcare and eHealth can help bridge this gap, making healthcare more accessible.
• Accessibility: Digital technology, exemplified by companies like Practo, facilitates easy access to medical specialists, patient reviews, and online appointment booking, addressing the issue of accessibility in healthcare.
• Availability: In rural areas, healthcare services are often scarce, leaving quacks as the only option. Training and mainstreaming them can enhance healthcare accessibility in these regions.
• Investment: The healthcare system in India faces challenges due to inadequate funding for preventive healthcare, professional training, and infrastructure development, particularly in rural areas. Start-ups can contribute to addressing these challenges by attracting investment and innovation.

 Government Role and Health Insurance

• Government initiatives like mass insurance schemes attempt to integrate private sector resources to provide care.
• Examples include Aarogyasri and Rajiv Gandhi Jeevandayee Arogya Yojana, with the national AB-PMJAY scheme covering nearly half the population.
• The Clinical Establishment Act of 2010 aimed to regulate health establishments and standardize costs.
• However, implementation has been lax or inconsistent across states.
• Private healthcare often resists cost control measures, especially when business is thriving.

The Need for State Investment in Healthcare

• Historical attempts at controlling private healthcare costs have mostly failed.
• Supreme Court’s intervention might prompt some changes, but significant challenges remain.
• Effective healthcare improvement requires substantial state investment in health funding.
• Current healthcare funding by the Indian state is among the lowest globally, complicating reforms.
• Healthcare is often overshadowed in political agendas by more immediate or emotive issues.

Source:Indian Express

Mains Practice Question:

“Despite numerous judicial interventions and policy reforms, the high cost of healthcare and the underfunded state facilities continue to burden the Indian populace.”