Last week there was a flurry of announcements from the Union government on measures to improve the state of Healthcare in India. One among them was the first step towards a Universal Healthcare model in India. If the Union government is to be believed, soon Government run hospitals will stop charging for primary healthcare treatments like consultations, basic medical tests and immunization.
Healthcare in India is almost entirely funded by individuals through out of pocket expenses.(Please see graph below)
Health expenses are a big reason for rural debt. People often borrow money from money lenders to pay for medical treatment of a family member. This leads to a scenario where these loans are repaid at high rates of interest over long periods of time. Moving towards free primary care would be a first step to raise the standards of living in rural India. By early detection and preventive care through primary health services, patients with a probability of requiring secondary and tertiary care is heavily reduced. This reduces the financial burden on the family as well.
The second reason that such a move will address is the absolute shortage of doctors in India. According to the Ministry of Health India faces a shortage of 6 Lakh doctors. But primary care can be provided by paramedical staff and healthcare workers, reducing the dependency on doctors. This way health services can reach a vast majority of our population with minimal investment.
However, delivering free primary care has its challenges. Firstly, the initial cost to set up the necessary infrastructure would be high. Secondly,as the service is free, there would be heavy patient inflow that would require more paramedical staff, health workers and nurses int he initial phases. Thirdly, it is the tax payer in the end who will have to bear the burden of free primary care. As the ratio of tax payers to non-payers is heavily skewed, the number of beneficiaries will far out number those that pay for such services. This would mean an increased burden on the government, that is already dealing with high fiscal deficit. Currently India spends about 5% of its GDP on health care and this would have to increase. Lastly, like any other government scheme, there is likely to be heavy mismanagement here as well.
In conclusion, universal health is a noble concept. India definitely needs one. But is it ready for one? I would love to hear your views on the same…