A news channel in India alleged recently that several private hospitals in the country were “exposed” by a “sting operation” to be levying fees in excess when COVID-19 patients went to them for care. It is not clear why a “sting operation” was necessary; the high cost of medical care in the top hospitals of the country is well known. Anyone who has had major surgery or received intensive care in any of the hospitals can testify to that. The debate now is whether such exorbitant rates are justified during a pandemic such as the one we are in the midst of , or indeed, ever.
Before we address this question, however, an equally important question arises: why do we have so many private hospitals in a poor country such as India. We have more hospital beds in the private sector than in the public sector. It is estimated that there are 19 lakh hospital beds, 95,000 ICU beds and 48,000 ventilators in India. Most of these are concentrated in seven States, Uttar Pradesh, Maharashtra, Tamil Nadu, Kerala, Karnataka, Telangana and West Bengal. Except for Tamil Nadu, Delhi and West Bengal, there are far more beds and ventilators in the private sector than in the public, according to the Center For Disease Dynamics, Economics & Policy.
A mirror to public care
The reason for this abundance of private health care is obviously the lack of adequate public health care. This situation has developed due to two main reasons. Since Independence, India has, quite rightly, focused attention on the larger picture. The priority in a developing country would be the provision of primary care at the peripheral level, preventive measures, immunisation, maternity and paediatric care as well as dealing with common infections such as tuberculosis. We have done this well, resulting in impressive improvements in many health-care indices in the last few decades. However, not enough hospital beds and specialised facilities were provided by the public sector during this time. At the same time, the burgeoning middle class and increasing wealth produced an explosion in the demand for good quality health care. Private medicine was quick to capitalise on this demand.
The second reason for the dominance of private medicine in India is the lack of adequate investment in public health. The Indian government spends an abysmally low 1.3% of GDP on public health care, which is woefully inadequate. Allocation has to be at least double this to address some of our pressing needs. Greater transparency and tighter administration are necessary to ensure that our resources are utilised appropriately. Specialists should be adequately compensated to obviate their need for private practice.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Private medicine in India is by no means uniform. It is estimated that there are more than one million unqualified medical practitioners, mostly in the rural areas. Most of them provide basic health care, charging a modest fee. Some may have claims of expertise (often unproven) in alternative systems of medicine such as ayurveda and homoeopathy. It is not unheard of them to sometimes venture into minor surgery. At the other end of the spectrum are state-of-the-art corporate hospitals, that are well equipped and well-staffed and which provide excellent service at high cost. These are often set up in metro cities at huge cost and have successfully engineered a reverse brain drain of many specialists from pursuing lucrative jobs abroad and staying back in or returning to India. Between the two extremes are a large number of private practitioners and institutions providing a wide range of services of varying quality. Some are run by trusts, charitable organisations and religious missions, often providing excellent quality at modest costs.
Source: The Hindu
