Giving life to India’s healthcare system

One of the biggest challenges India faces and will continue to face in the forthcoming decades is in the context of healthcare. It would include issues like health accessibility, infant mortality rates, the stunted growth of children because of ill health, maternal health, disease patterns among its adult population as well as the challenges pertaining to its ageing population, among others. It is bound to be further accentuated by processes like urbanization and ever-growing pollution levels.

The first and foremost challenge on the healthcare front will be addressing and tackling the diseases and understanding the disease patterns. Another related challenge is also to make health care affordable and accessible and to ensure that there is trust and synergy between the public and private health sector service providers and the common people. The challenge of access is also more pronounced because of the shortage of finance that results in a lack of infrastructure and manpower. Healthcare spending is a dismal 1 percent of GDP in India.

The private sector contributes 80 percent in healthcare, and ideally this indicates that the government should increase spending to a target of 3 percent of the GDP in the near future. The three-tiered system works poorly at the third level the primary healthcare centres. It is both because of the quality and quantity of manpower in the healthcare domain at this level. There is thus an urgent need to improve the quality and functionality of the primary healthcare centres within the country that at present is severely compromised. The contrary view is that the Government that makes budgetary allocation cuts towards healthcare has to be seen from a sympathetic view.

The sympathetic view is driven by the idea that it does not make sense to throw money at a system that hardly works, performs or is a big black hole. The ideas also push towards thinking that a new approach and system is required that redefines the way we look at the healthcare system in the country. The universal health argument boils down to two things. First, something needs to be done to remove people out of poverty and penury. It can happen only with greater opportunity for employment. Also, 40 million people are impoverished because of the health burden - out of pocket expenses.

The healthcare system has two cornerstones namely satisfaction from the health system and sustainability of healthcare system for everybody. Similar to the other social security schemes a social security scheme for health insurance should be floated that ensures increased health care from the scheme when the person suffers from an ailment. Thus, the government has to make a healthcare delivery framework where trust is embedded as the basis of the framework.

A new health system can be designed along with universal access only when medicines are looked at in a new light. It is because medicines play a key role for health needs in a developing country like India. . What is required is a system of checks and balances. This is where the country faces its biggest challenge, the challenge of dissonance between the political vision and effective implementation.

By Amit Kapoor