Is India battling an incurable healthcare crisis?
Millions of citizens are forced to choose private medical services they can't afford.
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Last December, I was experiencing some discomfort in my throat. I went to the healthcare centre in my university for consulting a doctor. The centre provides medicines and consultancy free of cost to the students of the university. To my amazement, the doctor at the centre prescribed medicines for my throat ailment without even examining my throat.
As expected, the medicines failed to provide me any relief. A doctor possibly can't diagnose a problem without carefully scrutinising it. Since the doctor never undertook the pains of doing so, he couldn't have suggested the appropriate medicine for the infection. That's the sad state of our public hospitals. Many doctors simply don't exhibit the kind of commitment that is necessary for curing patients. They have permanent jobs. Consultancy comes for free.
So where is the scope for additional financial benefits? That could be one of the reasons why doctors like the one I consulted show such less interest in their work. Not surprisingly, many of them open private clinics and hospitals where they flaunt the tag of their government hospital connection and make huge sums.
Several doctors in public hospitals illegitimately pursue government and private services simultaneously. Predictably, they are often late and leave for home (read private clinic) before time. Government hospitals are in a bad shape not simply due to the presence of dishonest doctors, but also because of serious infrastructural inadequacies.
Patients from across the length and breadth of India come to get treated at the All India Institute of Medical Sciences (AIIMS) in New Delhi. But many of them are made to wait for several weeks because of insufficient number of hospital beds. The poor patient, along with his/her family members, continues to suffer and sleep outside the metro station near AIIMS. This becomes even more frightening when one comes across the sight of patients shivering and sleeping on the footpath outside AIIMS in the bone-chilling cold of the national capital.
Coming back to my throat infection, I was pretty worried that my throat had showed no signs of improvement. Hence I went to a renowned private hospital in south Delhi. They told me that it wasn't serious, and a mild voice box inflammation. But not before they had charged me Rs 1,000 as consultancy fees. I paid an additional Rs 700 for the medicines.
In a country like India where per capita income stands at a pathetic US$1,631 (World Bank 2014), how many individuals can actually afford private healthcare? How many households can incur an expenditure of Rs 1,700 to cure a minor throat infection?
Private hospitals in the country possess sophisticated medical technology and specialist doctors. But private hospitals charge several lakh rupees to treat serious diseases like cancer and heart problems. Most Indians cannot access such expensive medical care because they earn less than a lakh rupees per annum. One of my college professors was once admitted to a private hospital following a medical emergency. Commenting on the cost of his treatment, he told me, "I went from being an above poverty line citizen to a below poverty line citizen."
Then there are issues of medical negligence. In August 2015, The Times of India reported that a patient died while a Japanese surgeon was performing a demo-surgery on him. The incident occurred as part of a "live surgery" workshop at AIIMS, New Delhi. To add to our woes, there is a complex medical-pharmaceutical nexus functioning in our country. Doctors are quick to prescribe medicines, mostly antibiotics, available at select chemist shops.
Such a practice does not merely lead to financial exploitation of the patient since the medicines are only available at select shops with a high price but it may also lead to antibiotic overdose which may in turn lead to antibiotic resistance. On December 8, 2014, New York Times published an editorial titled "India and the Post-Antibiotic Era" in which it talked about the world entering a post anti-biotic phase.
The editorial mentioned that in India as many as "58,000 babies died from anti-biotic resistant infections" in 2013. A study conducted by UNICEF in Telangana's Special Care Units (SCUs) found that in 13 of the 19 SCUs, newborns were being administered high doses of antibiotics in 55-98 per cent of the cases. As per data available with World Bank, life expectancy in India (2013) at the time of birth is 68 years. In Japan and Iceland, the average life expectancy is 83 years whereas in China it's 75 years. The data is reflective of how badly India's healthcare system is faring internationally.
The pitiable status of our healthcare sector is a cause of worry. Private healthcare is too expensive and reserved for a privileged few whereas public healthcare suffers from corrupt practices, medical negligence, technological and infrastructural handicaps.