“63 million people are faced with poverty every year due to healthcare expenditure” – a Health ministry report on 4th January, 2015. Economic growth, new jobs, higher pay would mean squat if the extra income would be spent on meeting the rising healthcare expenses, leaving little growth in savings or expenditure.
Costs of drugs and diagnostics constitute about 70% of health expenditure, and given that health insurance penetration is negligible in India (when compared to developed economies) and the fact that most insurance policies only covers your diagnostic expenses only if you are hospitalised for more than 24hrs, implies that more than 80% of the diagnostic expenses have to be borne by the patient.
The Government obviously realises the gravity of the situation and is taking great strides forward:
In his budget speech, finance minister Arun Jaitley stated: “To move towards ‘Health for All’, the two key initiatives i.e. the Free Drug Service and Free Diagnosis Service would be taken up on priority.”, and within a few months of the announcement, the Government is all set to announce the details of its free diagnostic service scheme (Source – TOI)
“The scheme is set to cover Blood tests (for detecting Diabetes, Dengue, Malaria, Typhoid & HIV, also including Liver Function Test, Kidney Function Test) and Imaging tests (like X-Ray, Ultrasound & CT Scans) and will be offered to those visiting public health facilities. Private service providers will be roped in wherever required.“
While the idea to provide free diagnostics has been (and should be) welcomed by most, there will be some serious implementation issues given the lack of basic public healthcare infrastructure in rural India. Private partnership will help in a big way but has to be regulated on the lines of the Central Government Health Scheme (CGHS) where services are offered by interested private players at pre-determined prices set by the Government.
Effective implementation will be the key to the success of the initiative but that being said, subsidies can never be a sustainable solution. Costs can be lowered in a sustainable manner only either through scale or through innovation. So the focus of the government should be to:
- Ensure that the basic healthcare facilities are up and running at every village in every district – this will also reduce the burden on premier public healthcare institutions and help them focus on more critical cases
- Fund research on low cost diagnostic devices – A smartphone today is more powerful than a computing machine 10 years ago and there is an abundance of smart phones even in rural parts of India, so why not fund research in companies that use existing infrastructure to provide very low cost and scalable diagnostic solutions for the masses?
Also ‘Swachh Bharat’ and ‘Clean Ganga’ initiatives will go a long way in improving the hygiene conditions and help India stay healthy, after all Prevention is always better than Cure!!