Shraddha Tiwari elucidates on the concept and the legal provisions pertaining to affordable healthcare.
Healthcare, etymologically, means the maintenance and improvement of physical and mental health, especially through provisions of medical services.
Affordable healthcare, in simpler terms, would be the accessibility of healthcare through reasonable pricing means. Providing affordable healthcare to all, till date, is an utopian idea, as one-third of the world’s poorest people live in India very few of who have access to healthcare. That is even after there being various programmes unleashed for it globally as well as nationally.
The major factors for causing hindrance to the affordability of healthcare are :
• Firstly, the big uninsured environment, and,
• Secondly, the disturbing allocation of public healthcare spending.
India currently just spends a 1.3% of its total GDP on healthcare, which is the lowest among developed and developing nations. But the affordability of healthcare has a huge scope of growth in India, as it is correlated with the economy, which directs a positive sign towards affordable healthcare as India is one of the fastest growing economies. The healthcare system in India is dominated by the private sector of the country, which should actually be the other way round, as the increasing demographics of the country are contributing to healthcare which will be a continuum.
Another issue to this regard is the non-fixation of fees charged by independent medical practitioners, clinics and hospitals. The fees varies not only on the basis of diseases, technology used etc., which is understandable, but also vary, to a large extent, from place to place. For tackling this and to increase the affordability, a regulator role needs to be adopted by Govt. in order to provide quality and accessible healthcare.
One of the visible instances towards lowering prices of healthcare is the setting up of a Medipark in Chennai. The Govt. gave nod to the establishment of the said park, which would be first of its kind manufacturing hi-end products, which would, thereby, lower the costs induced by technology, resulting in delivery of affordable healthcare combined with strengthening of quality healthcare services.
The lack of required infrastructure and workforce are more obstacles to the spreading of affordable healthcare. The total bed density has increased to 1.3 per 1000 by 2010, but remains significantly lower than the World Health Organisation (WHO) guideline of 3.5 beds per 1000. Also, private sector hospitals face utilisation issues whereas public sector hospitals face underutilisation issues. Further, the number of doctors and nurses also lags behind to what has been the WHO benchmark. This gap of insufficient infrastructure is evident from what has been happening since days in metropolitan cities due to the recent dengue outbreak, several hospitals are running out of beds causing high degree of inconvenience to all.
Healthcare, herein, is also inclusive of the drugs’ rates. The large population of the country finds it very difficult to afford the high branded medicines. Apparently, the generic medicines’ industries have therefore grown into a huge industry in itself. The Govt. has had launched “Jan Aushadhi”, which is responsible for regulation of prices of bulk drugs and their formulations, power to limit price variation up to ten percent of listed drugs, universalisation of VAT of four percent prohibiting sales tax and to reduce the excise duty and ensuring greater availability of medicines to the poor masses.
Public-private partnerships (PPPs) are the untouched aspects, which can provide the much required impetus and stability to the issue of affordable healthcare. Collaborations of both the sectors can result in greater positive outcomes especially, in terms of providing updated medical technology, which is very crucial as the advancement in the field of medicine happens on a daily basis. Such a joint venture success was visible in the state of Jharkhand ,wherein, a state wide Radiology PPP was launched and two more PPPs as an after effect in pathology were approved in the said state. In addition to this, there has been an array of other successful PPPs providing affordable healthcare in India. Such PPPs are needed to be carried forward and replicated in other parts of the country as well.
The absence of a strong social security system again supports the growing of a non-affordable healthcare system. The monopoly of LIC in Govt sector for giving health insurance has made the middle – class and upper middle – class population to turn towards the private sector, which a range of options to choose from. Again this kind of lack of a uniform social security system leaves the people belonging to the poor strata to claim healthcare services. The initiatives of insurance provided by State Govt. of Kerala have been proficient in increasing the number insured people for healthcare.
Although there has been provisions like the Rashtriya Aarogya Nidhi (RAN) for providing financial assistance to individuals belonging to below poverty line, however, the said programme in itself has many loopholes such as the limit for claim up to 1.50 lakhs of rupees by State Govt., only one-time grant to be permitted and above all this benefit can be only availed by the person in a Govt. hospital and when suffering from life-threatening diseases which is too vague to know. A total of three hundred and seventy six people did avail the services under RAN, but this number seems quite small and needs to grow rapidly in order to achieve equal and quality access of healthcare services and to witness a much needed breakthrough change.
REFERENCES AND CITATION
(1) Accessed from : “The Millenium Development Goals Report 2014” by United Nations New York, 2014.
(2) Accessed from : “Aarogya Bharat: India Healthcare Roadmap for 2025” by Bain & Company, Inc.A
(3) Accessed from : “Aarogya Bharat: India Healthcare Roadmap for 2025” by Bain & Company, Inc.
(4) Accessed from : “Aarogya Bharat: India Healthcare Roadmap for 2025” by Bain & Company, Inc.
(5) Accessed from : “Cabinet Approves Setting Up Of India’s First Medical Park” by NDTV; http://www.ndtv.com
(6) Accessed from : “Indian Healthcare: Inspiring possibilities, challenging journey” by McKinsey & Company.
(7) Accessed from : “Delhi running out of hospital beds as dengue cases cross 1,800” by Times of India on http://timesofindia.indiatimes.com/City/Delhi/Delhi-running-out-of-hospital-beds-as-dengue-cases-cross-1800/articleshow/48964660.cms .;and from “Dengue panic grips Chandigarh, hospitals run out of bed” by Times of India on http://timesofindia.indiatimes.com/videos/news/Dengue-panic-grips-Chandigarh-hospitals-run-out-of-bed/videoshow/54426911.cms
(8) Accessed from : “Introduction to Jan Aushadhi” on http://janaushadhi.gov.in/about_jan_aushadhi.html .
(9) Accessed from : “How India is using public-private partnerships to expand healthcare” by Pankaj Sinha on https://www.weforum.org/agenda/2016/01/creating-a-sustainable-health-diagnostics-network-for-low-income-populations-in-india-through-private-sector-participation/