Way Forward – A radical approach is required.
Disclaimer: This is a guest post from J S Augustine, Real estate and management thought leader, Mumbai. His views are sharp and informative. It gives an insight to current situation and how we can transform once the pandemic is over and out.
The underbelly of India’s healthcare is being exposed in the period of Coronavirus Pandemic. While in the West, it exposed the fault lines in the most advanced health care system, it will be a different story in India.
India with 0.53 beds per 1000 and public health system over crowded for a 130 crore (1.3 Bn) population is listed beyond 100 in the Health Index. This emergency will validate these numbers sooner (before the pandemic is termed to be over).
Soon India will have the world’s largest senior citizens and youth. A rare combination of probable economic asset coupled with a economic liability (requirement to provide care, with no or minimum revenue). India currently has both ends of health care – the Super speciality hospitals for the rich catering to less than 10% of its population, and a over crowded public health care (PHC) which is almost free or at negligible cost for the rest of 90% of the population.
The PHC has meagre tax collections over decades. However, a robust system can withstand any pandemic situation. Thanks to the pre- British fine-tuned system it is well improvised by the subsequent visionary governments over 70 years. Today, the UN bodies look towards India to handle the pandemic. will be handled. Our nation has proved repeated in the last 70-100 years its ability to handle mass outbreaks threatening the health. India reaches every house at panchayat level to Sanitise, Sensitise, Identify, Test and take Action.
In 2020 the Government of India needs to invest approx. 2.6% to 3% of its GDP on Health care to meet new requirements. A 10-point program could be useful to adopt.
1. Nationalise healthcare, like banking and insurance sectors. After 5 years it should be opened to the private sector again.
2. Invest min 2.6% to max 3% of India’s GDP in PHC.
3. Make Insurance compulsory for every Aadhar card holder. The Government should pay the premium for non salaried and IT payers. There are many models for this around the world to adopt.
4. Like Direct Cash Transfer, Goverment should pay premium to the Insurance company Direct Premium Transfer.
5. For 2020, immediately make allocation of 2.6% of GDP ie. 4.5 lac crores and target to create 1200 beds in every Taluka. We have about 5675 Talukas as on date. This will translate to 6.6 million beds.
6. Create a pan India Health Care institution (NHS) and have the pay scales of health workers uniform.
7. Treat this as War time emergency and make radical changes and implement it with surgical strike precision.
8. Ensure all Hospitals are of Modern standards with latest equipment.
9. Cancel all the unwanted expenditures on Statues, Central Vistas, Media budget. Every other spend should be postponed for 3 years on a war footing. Look at cutting down military arms purchase to create immediate corpus for healthcare.
10. Consolidate all diverse Health Schemes and bring them under one single Central Govt NHC Program and increase the Beds to 5 per 1000 from 0.53 per 1000.
The sudden lock down with a short 4-hour notice opened up a complex Pandora’s box – the migrant population, daily wage earners, lack of savings showed that India is surviving on a billion people. And they are dependent on daily wages both in urban and rural areas. It’s a blessing in disguise for the nation to know where we must place our priorities.
They seem to be saying daily, the Lord’s prayer ‘ … Lord Give us THIS DAY our Daily Bread…’ The Government may well use this once in a century opportunity to re-write the Healthcare system with a radical approach.
Thanks for Publishing this Nivedita Nagpal. Hope the policy makers can sincerely reboot Health Care in India 👍🏻
A timely eye opener and a wake up call for Indian policy makers. They should look at Indian health care sector on lines of UK’s NHS. All private hospitals should be nationalised.
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Well said Alok. The task is huge but not impossible. If we don’t do it now, we will never do it later
Thank you Augustine sir, for the unique observations. Hope our policy makers and influencers are shrewd enough, and they are addressing these:
“*Soon India will have the world’s largest populations of senior citizens and youth. A rare combination of economic asset and economic liability.*”
*”India currently has both ends of health care – the Super speciality hospitals for the rich, catering to less than 10% of its population, and a over-crowded public health care system which is almost free for the rest of 90%.”*