A friend of mine messaged me a couple of days back on Facebook. The message was a succinct but terse expression of his grief on medical negligence that caused the life of one of his friends. A doctor had ignored their pleas and did not attend to their grievances, which eventually caused his/her death. Now lets fast forward to today with the backdrop of the recent medical negligence that caused the lives of 48 children in Kunoor in Andhra Pradesh. This sequence of events draws an entire insight onto the public healthcare system in this country and also the out-of reach private healthcare.
Let's get the facts right on the public healthcare system. India's maternal mortality rate is 230 (deaths per 1000 people), it is worse than 116 countries leave alone China which has a rate of 38. India's mortality rate under 5 is 66 deaths per 1000 while even Bangladesh beats us with 15.India's infant mortality rate is 50 per 1000 when there are numerous countries above us.
On the other hand let me role out some statistics on the "other" India which invites medical"tourism": India private healthcare industry is growing at 8% despite the economic recession. The size of the Indian private healthcare industry is kept at US$35 billion dollars. It is growing at an alarming pace of 18%, the fastest in the world. 85% of India needs to spend out of their pockets to earn medication.
The paradox that this offers is alarming. The inequality so astonishes that when I started to research on the topic, I was taken aback. The issue with this entire disparity is not to do with talent nor has it to do with the lack of expertise. It has to do, to simply put it, with the prioritization of expenditure towards medicine and the excessive corporatization of medicine.
When you walk into a government hospital, you can see the filth all around you. It is very hard to pinpoint blame to a particular person on this. The patient is not at fault and the doctors who are underpaid are not at fault. Healthcare as a priority in this country is something that needs to be improved. Public healthcare is something that is taken so much for a ride that the only thing you could do is feel empathy for the aam admi stuck in this system. The expenditure for public healthcare is still stuck at 1% of GDP while the proposed 2% rise is still awaited. The priorities have laid elsewhere in covering other aspects of public life whereas the core essence of the poor man's life is taken for a toss. The hospital in Kunoor that fateful night had 43 babies but the capacity was just for 25. Some of them were reported not to even have oxygen masks. Such basic amenities were lacking in these hospitals. I can understand the notion that India is an immense country and it was not feasible to fulfill the complete demands of the inner villages but Kunoor with a population of 700,000 had only this much to offer? If we can spend thousands of crores in conducting the CWG games, all I can interpret is that it is a matter of priority in terms of our expenditure that is the issue. While lack of money haunts the public sector, the private sector is demanding too much of it.
Corporatization in medicine has gone to alarming proportions. Most of the elite hospitals cater to a niche upper middle class audience with the complete lack of focus on the people below the middle class line. The concept of medical tourism has risen to such proportions that this has become a luxurious medical carnival for certain sections of people. While it is admirable that our medical treatments are world class and helps others, the issue is that the essence of this excessive corporatization has ensured that there is a greater divide between Indians across the economic class. The lower middle class Indian can neither afford the astronomical costs nor can he have the burden of the "follow up" costs after the medication.
They barely can go to an economical private hospital because there are very few. Money calls the shots on most occasions. The best doctors end up at these posh 5 star hospitals, the best facilities are at these hospitals and the best treatment goes more often than not to the rich Indian or the average Westerner; not the Indian that needs it the most.
Instead of excessive corporatization, the focus should be on diversification of the medical pool across the country. The people belonging to the lower income groups should get treatment not necessarily on par but atleast 60% of what the elite get. The point is to ensure that the cream of the medical talent spreads across the economic divide. Furthermore, more investment from the public healthcare system is the need to attract this medical talent to the government hospitals and to do revamp on the infrastructure of the hospitals around the country.
It is a situation that pops up every time and fizzles away every time the dust settles down. One question that my friend (the same Facebook friend) asked me will never fizzle out of my head. He asked me "Is death because you are born poor? Can you bring back my friend or get me justice?"
All I could do is remain in stoic silence.