The protest of private doctors in Karnataka has a lesson for India
There is a lesson for the Karnataka government in this fracas: It must first put its house in order before challenging an established structure. In a poll-bound state, the Congress government may have found this a useful “pro-people” issue but such bravado minus any clear evaluation of the ground situation will not yield the desired benefits.
The face-off between the Congress-led Karnataka government on one side and private medical establishments and doctors on the other, over the Karnataka Private Medical Establishments (Amendment) Bill (KPME) 2017 may have ended in a truce for now, but it has lessons for the country. The agitating doctors called off their strike on Friday after the government agreed to make amendments to a contentious medical Bill that seeks to regulate the health sector and cap prices of treatment. The revised Bill will be made public today.
Private healthcare companies in the state had good reason to protest -- the bill would have hurt its profits -- and the Karnataka government eventually blinked because its public health infrastructure is not strong enough to absorb the extra pressure that could have come from a private sector shutdown. According to the Central Bureau of Health Intelligence National Health Profile 2017, Karnataka, one of the richest states in the country, spent only 0.7% of its gross state domestic product on health care, the third-lowest in the country after Maharashtra and Haryana. The national average is 1.1%. Karnataka also has the third-highest percentage of people (across states) who pay for medical expenditure through borrowings.
The Karnataka government’s move was well-intentioned, but pricing is a subsidiary issue. Interestingly, it isn’t t all that uncommon across the world. Japan, for instance, regulates the price of medical treatment and procedures very closely. It’s mistake was to address this issue without paying any attention to the broader healthcare policy. Then, this is true for all India. The country is yet to satisfactorily address the two basic questions of public health policy: Who pays? Who provides?