Outlook: Is Privatization the answer to providing quality Healthcare In India?

Healthcare, is a valuable service and surprisingly India has an investment of only 1.4% of its GDP in healthcare services. And this has been such, since decades.
If we compare this with the global story, the global average is around 6% with even countries like Sri Lanka being at 1.5%, China at 2.7% and Thailand at 3%.

What do these numbers suggest about government’s consideration in seeing Healthcare as a vital service?! 😐

You would be surprised to know about 65% of the households in urban and rural areas use private health care sector as opposed to the public health care.

Aren't these numbers highly disturbing?! They are for me, because as a diligent tax paying individual, I stand by the fact that providing for health care services lies in the domain of the government sector. The least I can expect is a necessity like health care to be facilitated by the government. And when I say healthcare, it is just not the healthcare but a quality health care benefiting one and all.

Public Healthcare in India follows a three-tier structure.

The primary tier constituting the sub centers, primary health centers, and community health center. The secondary tier constituting the district and sub district hospitals. The third tier constituting the tertiary care hospitals located in the urban areas. This division has been crafted to suit the geographic division of the country. Public health care although inefficient, tries to cater to people from the remote to the urban regions.

The government is trying its best but is still unable to cater healthcare services to the growing needs of the individuals. There are multiple bottlenecks that the public healthcare as an institute faces. To point a few:

• quality of healthcare not being at par 
• absence of hospitals 
• inconvenient timings 
• long waiting period 
• no health personnel 
• understaffed 

In situations like these, privatizing health care would hugely benefit the nation as a whole - and here we are talking about a nation which has maximum percentage of people not even getting access to healthcare.

The many shortcomings of the public health care could be easily handled by the private players, plus it could also attribute to improving the overall declining status of the healthcare in the country.

If we dig deep into the meaning of privatization - it widely refers to the transfer of ownership and management from public owned to private sector. Privatization includes a broad range of arrangements in its umbrella – contracting out, contract management and load shedding.
Contracting out states that particular services must be contracted to the private sector. The services could be the ones which impact a larger audience like cardiovascular diseases, children services etc., where the government would compensate the private sector in return of the services provided by the private sector.
Contract management involves certain services of the hospital being managed by the private sector but the accountability and responsibility still lies with the public sector.
Load shedding is when the overall responsibility is transferred to the private sector.

The utmost gap which privatization can bridge is infrastructure. Public sector hospitals although built, are majorly insufficient to treat a wide range of diseases and ailments. They are either unequipped in terms of the facilities or equipment or treatment. An example of it would be the Gorakhpur case, where about 23 children died to absence of oxygen at the BRD Medical College. This was a huge failure and shame in the part of the country, to see innocent children dying. Private players on the other hand, hold the capability to build hospitals with good infrastructure along with provision of the latest facility, latest medical equipment, resources, nursing, hygiene and personal care, manpower, better diagnosis with the presence of adept, competent doctors and attendants. It can provide for the best of the treatments for the ailments that people face. This in turn would yield in the increase in the accessibility of the healthcare which still stands as a major issue today. As and when the availability of healthcare increases, it will result in people having more options to choose from where they wish to be treated unlike the limited public hospitals. It would also entail in a healthy competition in providing the best services at best price.

Another problem that the sector faces is that of maintainability. Classic example would be abuse of expensive machines even when installed in the hospitals are made defunct by high misuse or unawareness.

The availability of manpower plays a crucial role in setting up the bar of the quality of healthcare imparted. You would be surprised with the doctor to patient ratio, for example in Barsol in Kolkata, the government hospital has a ratio of doctor: patient as 1:1500, which is extremely frightening. The WHO prescribed limit is 1:1000. I can only imagine the plight of the doctors and patients. Also think about the significant delay in the right treatment reaching the patients i.e. the waiting time being so long. In healthcare, every minute counts.

The other benefits it brings along is contribution in the skilled and unskilled employment.

Finally the biggest advantage the private players bring with them is access to funding. Funds are crucial for every medical activity and we have already seen how India lags in the average spending level for contributing to healthcare from its GDP. With funds flowing, greater chunk of the crisis can be brought under control.

 Privatization in India is a tough task to implement as it must penetrate the three-tier structure of the public healthcare system, for people to maximize the benefits - but it can bring out huge benefits in terms of bringing along new level of efficiency, innovation and R&D.

I am not saying privatizing the health sector ,will not come with its own set of pros and cons - every coin has two sides, isn't it?!

The cons, what I see here is the rising cost of the health care. The cost of the quality and accessibility to healthcare is to be borne at an expense of huge holes in the pocket. This might again cause issues for 25% of the population who still access public hospitals. Example – At Fortis hospital, treatment of a seven year was billed to almost 15 lakhs of rupees. This rising cost might further attribute to poverty which might be a worrying issue, given the average income of an Indian is about 1670$/year.

Despite the cons, still somewhere I largely agree that privatizing is the quickest solution to providing quality health care. Healthcare beyond everything. This would definitely need aids from the government in the form of definite government regulations. There have to said regulations in medical treatment costs and medicine costs. Example – Recently the government slashed prices of the coronary stents by 85%, which was a big step towards cost reduction. Government has to reform in a way that it can pull private players into the public healthcare domain.

It is not a one man's job - government, business and society need to come together, work in a close-knit model to be in a win-win situation and march ahead.

Cheers to life!!

~Believe in yourself always!

© Please do not use the above content without my permission - it is part of my project work at IIMB.