‘The government should allocate atleast four to five per cent of its GDP to healthcare’

Healthcare spending by the government

Last year, the government spent a paltry one per cent of its GDP on healthcare but last year’s budget promised to hike it up. Various economic surveys claim that India has the lowest health spending as proportion of its GDP. In fact, though the number crunchers say that we spend 4.1 per cent of our GDP on health the fact is that 70 per cent of it is from people’s own pockets or private spending meaning that the government spends barely 1 per cent on health. We propose that it should be increased to substantial amount. Currently, India falls under countries, which spends the lowest on healthcare in the world – 171 out of 175 countries in terms of public health spend. The Nigerian and South African government also spends more percent of its GDP on healthcare.

Healthcare infrastructure

Given the growing population, changing demographics, disease profile and shift from chronic to lifestyle diseases there is a need for an enormous amount of investment in coming years to enhance and expand India’s healthcare infrastructure. In most states the government healthcare infrastructure are not up to the mark. If the government does want to achieve its oft-quoted dream of Universal Health coverage – then granting industry status is very important. It would allow hospital groups to expand faster, newer ones to come up, hire more doctors and also allow foreign direct investment (FDI) in healthcare. The industry status would also ease up the process of setting up standard medical educations and increase public-private partnership in the healthcare sector.

Healthcare delivery

Influx of investments in the healthcare sector will provide a comprehensive range of state-of-the-art tertiary and quaternary care. It will help offer a broad range of acute care inpatient services and extensive outpatient services along with long-term care facility.

Healthcare manpower resource

Presently we believe that there is a huge shortage of trained manpower in healthcare, especially the paramedical staff. There is a need of more number of government medical and nursing institutions from where trained healthcare candidates who want to serve the society are churned out.

Medical education and training

Presently there are very few standard medical colleges in India. We need more such government medical institutions, which churn out good doctors and nursing staff. Unfortunately the curriculum in India has not changed for more than 40 years. Today, medical students across developed world follow problem-based education where in they get hands-on training from the day they join a medical college, unlike India. Also the post-graduation seats are limited, which if increased will help in churning out more medical specialists.

Medical devices and disposables

The duty on import of medical devices and disposables should be reduced to encourage the development of quality and affordable healthcare to all. This will help bring down patient costs, particularly those that can’t be manufactured in India. Lower duty will also allow hospitals and doctors to charge less for expensive procedures.

Taxation policy for hospitals and other healthcare providers

There should be a tax holiday for at least 10 years for the new private hospitals coming up in the tier II and III cities to cater the semi urban areas with quality healthcare. This will also encourage advance healthcare facilities in these regions, which will also interest expert doctors to serve these areas.

Insurance

Policies need to be adopted to ensure the larger section of the population is covered at least for the basic healthcare. India must move to a system of universal healthcare coverage, in which not only hospitalisation but medicines and outpatient care are also covered. There are some state health insurance plans in states and one that covers a small portion of the people on a national level. These plans need to serve as the basis for building a vibrant new national health insurance plan

Public health policies

India’s public health infrastructure is in shambles. Government should spend more on public health services. The government should allocate atleast 4-5 per cent of its GDP to healthcare. Along with investment, improvement in public health system and management is also required. Also a special public health cadre should be formed to improve the quality of health workers.

Disease focused policies

Public health policy must, in coming years, be directed as much towards non-communicable diseases as infectious ones. Government should adopt a far-sighted approach and focus on prevention and management though awareness than just treatment.

Public private participation

Government should encourage PPP model. Healthcare institutions, which are not managed properly in primary, secondary and large hospitals, should be identified and PPP model should be adopted for these. The PPP model can be executed very efficiently if proper infrastructural development is applied upon. Wherein there is proper planning and management is systematically functioned. The government should introduce the concept of mobile clinics, which can go to the remote areas of the cities or reach the people who are unable to reach the facility. For more than 90 per cent of the population in India today, modern healthcare facilities are still unaffordable so there is a need to bring down the cost of providing healthcare and PPP model is one way of doing it.

– Rekha Dubey, COO, Aditya Birla Memorial Hospital