Good, Bad and the Ugly

Onions and crying go hand in hand. Have you heard of onions which do not make you cry? That is exactly what some scientists in New Zealand achieved, in collaboration with the botanists in Osaka, Japan. The teary vegetable was genetically modified to create the welcome variant. A total overhaul; a complete change. That is what has happened to the healthcare industry in the country. Covid-19 has irrevocably and exhaustively changed the very DNA of medical care in India. When the dust finally settles, there will be no similarity to its original form. Healthcare industry has been altered for good into an unrecognizable form. Now, there is no turning back!

• The Good. There is a recognition that the percentage of GDP spent on healthcare in India is abysmally low and that this needs to change. The government seems to have woken up to this reality. Our expenditure on public health is approximately 1.3 percent of the gross domestic product. The current experience has revealed to all and sundry that our preparedness for any health catastrophe is woefully inadequate. This will, hopefully, help us prepare for future eventualities… a much-needed wakeup call! The flip side is that the benefits of this paradigm shift will take time before becoming evident.
• The Bad. Covid 19 is a trickster. In addition to the acute emergent health needs, the second wave of the pandemic has produced many patients with chronic health conditions. There is an endless parade of bizarre symptoms. Pulmonary cripples are those who have had decreased lung function because of severe damage to the lungs – those who live with residual problems. Respiratory, physical, and psychological dysfunctions are now recognized sequelae. We must learn to live with these new entities. In addition to all this, there is the additional burden of healthcare workers who were victims of the disease themselves and continue to bear the sequelae.
• The Ugly. The economic devastation and the trail of destruction of livelihood left behind by the pandemic has been unparalleled. Rising wholesale inflation will result in retail price rise. Unemployment rate in April this year was estimated to be approximately 8 percent. Just last month, CRISIL announced that the current recession is likely to be the worst since independence. According to one of the reports from the Azim Premji University, the pandemic has pushed 230 million people to levels below the poverty line (defined as an income of `375 per day). The lower income groups have been inordinately affected. This results in denial of access to health among the masses. Chronic illnesses are totally neglected. Tuberculosis, hypertension, diabetes mellitus and cancer care are severely adversely impacted. Regular immunisations and children’s nutrition are no more priority areas. The long-term results of all these ground realities will be catastrophic. Access to healthcare depends on the purchasing power of the individual in our country because socialized medicine is not yet available to most (barring a couple of states). Over 80 percent of the people depend on private healthcare. This demands much attention from the planners to avoid a socio-economic holocaust with major health implications.

How shall we play our part in view of these realities? When the going gets tough, the tough get going! It may be cliché… but this is the time to demonstrate our resilience and relevance as private healthcare provi­ders. This is also the time to show that we care… care enough to be relevant to the common man. We will have to strike a balance between being socially equitable and being sustainable. Corporate social responsibility has become very important and relevant during the current scenario. We will never be able to satisfy everyone; we will never be able to fulfil what the government should do… and yet, there is a sense deep within, which prods our conscience, telling us that this moment is a divine appointment in our journey. History will judge us if we fail to play our part, or laud and salute in hindsight. It is time to show the humane side of private health care. Much has been done already; it is important to acknowledge and make known the exploits and the heroics of our folks. It is also time to reign in the very few among us who stray.

I am reminded of a quote from Denis Leary, the Irish American actor, comedian and writer: Crisis does not create character; it reveals it. It could very well be that we are at the cusp of a paradigm shift due to the most significant health care crisis our generation has ever seen. Time will tell if we are equal to the task ahead. For the sake of the nation and for the sake of humanity, I wish the verdict will be in the affirmative.