1. Home
  2. The Ailing Healthcare

The Ailing Healthcare

The holy scriptures depict a doctor as next to God and extol the profession as noble. Voltaire, a French philosopher of 17th century had said, “Those who are occupied in the restoration of health to others, by the joint exertion of skill and humanity, are above all the great of the earth. They even partake of divinity, since to preserve and renew is almost as noble as to create.” Why then are doctors attacked by the very people they are supposed to heal and treat?


The most recent case saw West Bengal on the brink of a medical crisis as doctors in the state protested seeking, those found guilty to be punished, when the kin of a patient’s death triggered the initial violence, at a State administered medical college and hospital. The episode alleged both sides attacking each other. An immediate fall out has been hundreds of patients suffering for want of medical attention when the medical fraternity stopped work, in various parts of the country. Trust is important in any healthy relationship. There are more than 9,000 billing codes for individual procedures and units of care. But there is not a single billing code for patient adherence or improvement, or for helping patients stay well. Are we seeing a deficit of trust in a doctor – patient relationship?


Should private care be regulated? Do we need private security in hospitals to protect the care givers? There were two recent incidents: the death of a seven-year-old in a Gurgaon hospital after her family was charged Rs 16 lakh and a 22-week-old baby being erroneously declared dead by a Delhi hospital. Both resulted in skirmishes between the doctors and the families of their patients. Medical negligence often is difficult to prove. Medical error, even more. All this in spite of the medical protocols in place. A thin line separates medical negligence from medical error. How does it matter to a patient’s family? What is worrying is the alarming regularity of such cases. Even the American healthcare system has its faults. In the US, medical errors are the third or fourth most common cause of death. Can we brush it aside remarking ‘doctors are also human’?


What are the working conditions like in India? A doctor in US or Europe works for 48 hours a week. In India, doctors are expected to work 24/7. In a country of 1.3 billion people, we are woefully short of doctors, nurses and specialists. For about 63,000 doctors passing out across the country each year, only 14,500 specialist’s graduates. Many of them go abroad. So how does one get the personal attention which every patient deserves? Even the para medics and support systems are inadequate.


As much as recognising that we need more doctors, we need more hospital beds too. It is extremely important that the government creates a financial intermediary to pay for healthcare. A record four million passenger cars and commercial vehicles were sold in India in 2017. In addition to this, India’s two-wheeler industry sold about 20 million motorcycles in the 2017 fiscal year. Every one of us spend at least Rs 150-250 per month just to speak on a mobile phone. The country’s telecom subscriber base crossed 120-crore mark according to a report released by TRAI. Even as little as Rs 25 levied on these services can build hospitals in tier 2 and tier 3 cities. It probably can even fund the PM’s ambitious plan the “Ayushman Bharat-National Health Protection Scheme”. Private healthcare works on cross subsidy where somebody pays a little extra to fund someone who cannot afford.


Doctors also have aspirations. If an environment that breeds anger and vengeance is promoted, more doctors would probably leave and never come back. Unless we improve our medical education delivery systems, where we produce 1000 doctors for every 100 that leave, the current situation may never improve.


Are our hospitals and treatment that we get overpriced? Cost of tangibles like medical equipment, rent on infrastructure, or a day’s stay in the ICU or cost of the ventilator support and medicines can be recovered on cost basis. Even depreciation and interest paid may be recovered. A look up table or a ready reckoner can be created for this. However, the doctors’ fees is the value he assigns to his intelligence, his experience and the dexterity of his hands. In a way the costing has components that are possible to estimate. Why then the policy makers and the medical fraternity not converge on pricing?


The fourth estate seems to be onto every case even before it happens. Information, misinformation, morphed information and motivated information, every bit of action is reported which also travels thick and fast on the social media. Facebook Livestream will even beam the action live into the drawing rooms with no scope for reproach or time to understand what really has happened. The daggers are drawn and a fight is on so to say. The press gloats the action was brought to the viewers by their channel the first, like it was some soap opera. Have doctors, patients and our hospitals been reduced to TRP boosters? Innovation and going the extra mile are not part of rules and procedures in any profession. If the doctors stick to just the procedures that are legally tenable, we will have more people succumbing to their injuries.


The pharmaceutical industry in India was valued at US$ 33 billion in 2017 and is expected to reach US$ 100 billion by 2025. A major concern in India is the pharmacist deciding what medicine the patient will take and the unholy nexus between him and the doctor. Over the counter prescriptions and no bills sought, nor given for generic or even branded medicines is the bane of effective healthcare. The Indian pharmaceuticals market which is the third largest in terms of volume and thirteenth largest in terms of value, as per a report by Equity Master, accounts for approx.1.4% of the global pharmaceutical industry in value terms and 20% in the volume terms. Generic drugs account for 70% of market share by revenues, over-the-counter drugs follow at 21% of revenues and patented brand name drugs at 9%. The healthcare market is massive by any means. There never will be recession in the healthcare business. Enabling reforms are what the doctors prescribe for otherwise, our health care system will be neither healthy, caring, nor a system.”

(Visited 1 times, 1 visits today)