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Healthcare for all needs collective action

India will emerge as the first country in the world to dissociate healthcare from affluence, writes Dr Devi Shetty, Chairman of Narayana Hrudayalaya.

india Updated: Nov 08, 2008 00:52 IST

India will emerge as the first country in the world to dissociate healthcare from affluence.

While it’s the norm across the world that the quality of healthcare depends on one’s bank balance, in welfare states like the United Kingdom, the governments cross-subsidise healthcare delivery through taxpayers’ money. However, the economic crisis has put both the American and British systems under tremendous pressure, some even warn they’re on the verge of bankruptcy.

There are entities in India working towards a model of healthcare delivery not linked to what people can afford. If this works, we believe that within the next seven-ten years, a large number of Indians will have access to the best hi-tech facilities.

Is it utopian? And, how is it possible in a country with a population of 1.2 billion?

Ironically, India produces the largest number of doctors, nurses and medical technicians in the world. These are the people who predominantly deliver healthcare.

The problem is — our people who need them the most can’t afford them. There is no mass-scale health insurance that can offer efficient and affordable solutions. The turning point will be to bring in MNC-like financial support systems.

Five years ago, we introduced such a concept: a micro-health insurance programme. The model was adopted by the Karnataka State Cooperative Societies. Through the Yeshaswini micro-health insurance programme, the state government proved that even with a monthly contribution of Rs 5 from a farmer and Rs 2.50 from it’s side, it was possible to pay for any surgery —cataract to a major heart procedure.

Yeshaswini has grown and covers nearly 3 million farmers, each of who chip in only Rs 10 a month. Its success has seen the launch of Arogyashree in Andhra. The West Bengal government is launching a scheme for primary teachers with the National Insurance Company.

These are just some examples. The beauty of the exercise is that the governments are realising that it is easier to become health insurers than healthcare providers.

Infrastructure? The private sector accounts for more than 80 per cent of healthcare spending in India. It’s very important that the government provides incentives for health cities with 3,00-5,000 bed facilities, where the number of procedures can bring down costs. If UP or Bihar government choose to launch health insurance schemes, there’ll be enough to go around.

India may produce the largest number of doctors, but only 10 per cent of them specialise. We need thousands of specialists. For that, changes in methodologies and structures of programmes are needed. A transformation in healthcare and delivery systems will require collective action, if India is to become the first country to dissociate healthcare from affluence.