Healthcare in Present

“Hospitals have become large industries now based on human distress and we cannot let them prosper at the cost of lives. Let such hospitals be closed”.

प्राइवेट अस्पताल बड़े उद्योग बन गए हैं। उन्हें जीवन की कीमत पर समृद्ध नहीं होने दिया जा सकता। बेहतर होगा, ऐसे अस्पतालों को बंद कर दिया जाए।

This recent statement by the Supreme Court clearly indicates what went wrong with the privatization of healthcare services post-L.P.G reforms of 1991. When India got independence, there were around 7000 hospitals for a 353 million-plus population. Makers of the constitution knew the importance of health in wealth creation and nation-building, that is why they incorporated them in the directive principles of state policy-wide articles 39(E), 42, 47 but not as a fundamental right because state finances were not sufficient at that time. The Constitution further directs Panchayats and Municipalities under article 243G to strengthen public health care facilities.

As Public health is a state subject under the 7th schedule, it is the duty of state governments to ensure equity, accessibility, and timely healthcare services. If we talk about the state’s role, they have the overwhelming share (87.5 % in 2019–20) in government spending on healthcare. Total healthcare spending by health ministries of the Centre and states was 1.1 percent of GDP in 2019–20 RE, up from 0.9 percent of GDP in 2015–16. States get their funding through CSS health schemes like National Health Mission (NHM); Rashtriya Swasthya Bima Yojna (RSBY); and Pradhan Mantri Jan Arogya Yojana (PMJAY) apart from their own revenue.

If we see the overall picture, current health expenditure as a percentage of G.D.P is 3.5 % (2016–17 data) [For the U.S.A it is 16 % ]; per capita expenditure on health stands at 58.7 % of out of pocket expenditure in total health expenditure with all India average of 4381 INR. The percentage share of private hospitals in hospitalization cases stands at 55.3 % with average medical expenditure per hospitalized case as a percentage of GSDP per capita with all India average of 21.9 %. As a percentage of total revenue expenditure on healthcare, Delhi comes first (16.7%) while Bihar comes last (5.9%).

In terms of the workforce, the number of medical doctors is around 8% per 10,000 population and the number of nurses and midwives is 18 % per 10,000 population. In which Delhi comes first with 12% and 24% respectively while Bihar comes last with the respective percentage of 4% and 2%. The share of private hospitals in hospitalization cases is 57.8% on all Indian bases while hospital beds in a government hospital and medical colleges stand at 6.5 per 10,000 population on an all Indian basis. This data clearly reflects the role; the private sector is playing in healthcare services. With the advent of the private sector, health services have become expensive and class-based. Those who are able to afford them now, may not be able to afford them in the near future as the health care industry is witnessing a high inflation rate.

According to the Ministry of Statistics and Program Implementation and S.B.I research points that Health inflation has increased to 8.4% and 7.7% in May and June 2021, respectively, from 3.8% in December 2019. A closer look at the health sub-group points to a consistent increase in the prices of medicines (8.6% y-o-y increase in June), medical tests (6.2%), hospital charges (5.9%), and consultation fees (4.5%). With services becoming costlier, the only way we are left with is taking insurance cover which is evident by the market size of the insurance sector (US$ 280 billion) in 2020.

As per the World happiness report 2021, India ranked 139 out of 149 countries while Pakistan (ranked 105) and China (ranked 84) are way ahead of us in terms of delivering happiness to their citizens. One of the initiatives, the state can take is to provide accessible, equitable, and quality healthcare to its citizen which will upgrade the quality of their lives.

Can you relate to the statement?



Engineer by degree, a Teacher by profession

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