Health care reforms in India too need reforms as we need reforms in many other sectors: electoral. police, judicial and administrative.
6 decades of free health care policies in independent India have not brought succor to the larger percentage of population. Those at the base of pyramid do not have access to the basic health care. The central and state governments have spent massive amounts on opening and maintaining large hospitals to small dispensaries: the services are more or less free. Yet we have dismal performances being seen: they are best characterized by inefficiency, maladministration and waste of resources and poor work-ethics.
What is the solution: open more efficient hospitals? No, stop spending further money on this wasteful exercize. In my opinion, the following steps should be taken:
1. Govt hospitals be replaced with health insurance: Open no more govt hospitals, rather gradually abolish this system. Government must provide health insurance cards to each and every family. The concept of sliding scale in deciding premiums can be applied: to the families below poverty line, these insurance cards can be free , while those with high incomes, the premiums can be higher. Families can be given the option to opt out.
Any person with health insurance can get health care from the eligible health facilities (generally, private sector).
2. Regulate private health sector: Let the private health care sector prosper, but the govt must bring in strict regulations how the clinics, nursing homes and large hospitals operate. The current private health care sector in India is highly un-regulated, hence malpractice is prevalent. They often exist to reap maximum monetary benefits, while quality of health care and ethical practices are generally given low priority. A highly regulated system will help curb malpractice.
3. Govt to provide public health: The government must continue to provide preventive health services: vaccinations/immunizatiions, ante-natal care,etc.
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Yes,the Govt hospitals have actually become treatment centres for the neta-log.Look at AIIMS in Delhi.There is a special wing and ward for the netas whereas the common man has to wait in the open and sleep in the verandhas till his number is called,which could be few days.It must be same in most of the cities.To provide free luxury medical treatment to netas,you and i pay taxes and still remain deprived of the basic facilities.Thank you for bringing-up this subject.
It is a fabulous idea for the countries like India where common men are treated like cattle and are deprived of basic facilities of health care and proper medication. It is already successful in America and will certainly improve the much deteriorated scenario of govt. hospitals when the insurence companies would take the charge in their hands. I wish all the success to the project if it comes to the floor. What I doubt most is that can our most incompetent and incapable system which could not even prepare a flawless voters' list would be able to issue the cards to every citizen of India honestly and secondly with ever increasing number of illegal immigrants from neighbouring countries like Bangladesh and Nepal who are merged with Indian people inseparably how it would be possible to identify the genuine lot ?
All the points are valid and relevant. However, the basic reasons given for this radical suggestion is ineffeciency,maladministration, waste of resources and poor work ethics. But these are the hall marks of any department of the government not just hospitals.Better governanace is the immediate solution. However, if government resources and private management skills can be combined, we have better chance of success for revamping the system. Can we think of Public Private Partnership (PPP) model extended to healthcare sector? If government pulls out of setting up hospitals, who will set up hospitals in villages; which doctors and specialists will migrate to work in villages? Finally poor sick man may have to come to city with increased burdeon of travel costs for everything and inconvenience as well. The insurance model in US or NHS in UK both have their plus and minus points. We need home grown solution to optimise resource utilization, cover huge geographic and demographic profile. Our most important asset is the highly successful and easiliy available teams of doctors and nurses which other countries lack.We have best of healthcare professionals' pool and streams of alternate medicines which all can be harnessed for well being of large population (even above poverty line)which can not afford to pay even insurance premium. With medical tourism being touted as important strategy there should be no dearth of investment from private sector which will focus only on cities. Can foreign direct investment be opened up for setting up hospitals in rural areas or district levels? Can a group of qualified healthcare profesionals prepare and submit a detailed paper to say All India Medical Council, CII or FICCI to take up matter with the policy makers and planning commission?
Vijay M.Deshpande
Pune
मनीष जी आपका सुझाब अच्छा है की सरकार को अब और हॉस्पिटल खोलना बंद कर सभी को हैल्थ इंश्योरेंस कार्ड प्रदाय किया जाना चाहिए . और साथ मैं यह भी की गरीबों को प्रीमियम फ्रेम हैल्थ इंश्योरेंस कार्ड प्रदाय किया जाना चाहिए . और इस प्रकार हैल्थ इंश्योरेंस कार्ड धारी कोई भी व्यक्ति किसी भी एलिजिबल प्राइवेट सेक्टर से स्वस्थ्य सुबिधा पा सकने का हकदार होगा .
किन्तु प्रश्न यह उठता है की क्या प्राइवेट सेक्टर पूर्ण समर्पण के साथ गुणवत्ता युक्ता सेवाएं प्रदाय करेंगे . क्या देश की गरीब और भोली भाली जनता को उनका बाजिब हक़ देते हुए उनके साथ न्याय कर पायेंगे . और यह भी की जब देश के प्रशासन तंत्र मैं जो अव्यवस्था फैली है उसे देखते हुए क्या यह कहा जा सकता है की प्रशासन , प्राइवेट सेक्टर पर सख्ती से निगरानी और नियंत्रण रख पायेंगे . फिर भी ऐसे नए सुझाबों पर गंभीरता से विचार किया जाना चाहिए .
धन्यवाद .
i want to mention something about mediclaim policy
whever you are interested for doing a mediclaim policy your agent will make each & every commitment but in case of any claim it is not reimbursed though the policy is cashless
it is a big problem
one my colleague last year have some problem and gone for surgery, she is having her policy since last 8 years and made no claim during 8 years but to get reimbursement she suffered a lot
what is the solution for this
This may appear to be a suggestion to divert funds spent on government hospitals to the private medical hospitals.
I do not think this diversion of funds or insurance is the priority. We need a feedback system and citizen education mechanism that reduces the occurence of diseases. Whiih are the deadly disceases, by community of lifestyle groups, by region / environment? How can this be improved? Can we have statistics to measure these that are improved year on year by taking whatever emasure it takes? Shift focus from 'treatment only' to prevention. Much of this may feedback into government organized / monitored public health impacting programs. Sanitation, water supply, air pollution, adulteration.
If people drink / smoke / lead a promiscous life and get disceases, this need not be a cost to society by insurance. But if it is due to a polluting industry, let all the attendant welfare costs be slapped to the offending industry.
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