Is that a dumb question?

Why pays your healthcare bills ? The answer is obvious right, its you.

But if you are an American citizen or a British subject the answers are very different.

The American healthcare system is based on Health Insurance. So if you are insured then the Insurance company pays your healthcare bills. Obviously there are premiums and co-pays at the time of the treatment but more or less the insurance company picks up the tab.

In England and most of western Europe, the concept of Universal Healthcare prevails. That means the government assures you that you have a fundamental right to health. So there are Govenrment funded institutions like the NHS, which picks up your hospital bills.

So in India why don’t we have insurance or government picking up the tab?

Well there are insurance  firms in India. Around 4-10 % of Hospital bills in India are covered by Insurance either corporate or personal. But unlike the US Indian Insurance firms don’t cover Out Patient visits. So the Insurance comes into play only if you get admitted. Also Insurance overall increases the cost of Healthcare like it has done in the US.

What about the Government?

Well the Indian Government has to run railways, an airline, manage PSUs and banks, hence finds itself slightly overwhelmed when it comes to the subject of healthcare.

Under the Central Government Health Scheme and its state variants, the government does cover its employees. So roughly 10 % of hospital bills are covered by government and it may rise to 13 % if you cover Defense.

That means that almost 70 % of the hospital bills are covered by the individual. Shocking isn’t it?

This is the single most important reason for rural indebtedness.

I was speaking to my physiotherapist a few days ago and she recounted a horrifying incident in this village in Andhra.

She said that if someone was ill and dying and his chances of survival looked bleak, the village people would just lock him or her in a room and wait for him to die. The health facilities were so far away and expensive that the village could not afford to spend the time and effort to take the patient to a health center.

This is the bitter reality of the India we will live in where a baby in the city with a congenital heart defect can be saved but not a rural patient with typhoid.

But how does one deal with it? And are there ways and means by which we can reduce the cost of healthcare?

For all that and more please keep watching this space.