Healthcare in 2024 and beyond – Poised for the big leap forward, but unwavering focus on research is imperative

In the next two years, given the rapid strides in terms of technology-led disruptive innovation, healthcare industry in India will most certainly achieve significant growth, approximately in the 10 to 15 percent range. Most analytical reports on India are invariably promising. While our middle class is growing in prosperity by leaps and bounds, it is believed that we will in good time have a 10 crore population of affluent people earning over ₹10 lakh a year. Naturally, this populace will seek high-end healthcare and it is obvious that private players will provide the bulk of these value-added services. Already, private healthcare serves a whopping 76 percent share of India’s total healthcare needs.

Looking ahead, I foresee two key growth drivers emanating from this conducive environment. The first is a noteworthy boom expected in private insurance over the next few years. Consequently, we will see more cashless transactions as more people will become part of the insurance coverage. Of course, government schemes will continue to make a positive impact through subsidized treatment largely for poor and deprived patients. It is heartening to note that the government is now proactively exploring ways and means to improve the quality of subsidized care, which may in due course result in better reimbursement models, and expanded coverage to include more people in insurance schemes, not merely those below poverty line.

Having said that, the healthcare sector collectively needs to focus on improving the quality of clinical excellence and treatment outcomes. Ideally, the government should play the role of a monitoring agency, overseeing the performance of private players in terms of patient care and treatment outcomes, as also incentivizing the better performers and penalizing the errant.

Talking of the regulatory scenario, it is still discernibly bureaucratic and too stringent for comfort, especially in the critical space of clinical trials. I hope this area will see a wave of liberalization it so deservedly calls for. I am afraid our import policy needs a radical transformation. It is difficult to understand why custom duty should be imposed even on critical, life-saving equipment. This unfair levy should be removed in the best interest of the healthcare sector and its stakeholders.

Further, government spending on healthcare needs a big boost. It has remained insignificant for too long. Research is one key area where both public and private investment needs to be increased significantly. Currently, it is less than 1 percent, which does not augur well for the sector’s all round development, especially in an era of evolving threats to human life from diseases caused by disorder-prone lifestyles, environmental factors, and genetic triggers. Without research and development, we simply cannot compete with the best-of-breed players of the global market. Fundamental and applied research alone will help us raise our benchmarks for clinical excellence in line with global standards.

It is imperative that the government provides key support in the form of substantial grants and funds to the capable and conscientious research and academic institutes, irrespective of whether they are public or private. Last but not the least, the government should proactively promote and support the indigenous production of medical equipment. Beyond the slightest doubt, government support can make a significant contribution toward improving the sector’s prospects and performance.

For the vast majority of common folk in India, access to quality healthcare remains a distant dream. Despite the growing number of private hospitals in small towns, many people are still deprived of the right treatment at the right time. India needs to vastly improve the quality of its primary care. States like Orissa have shown the way through grants to empanelled hospitals for providing free treatment to deprived communities. Other states can explore similar models to make primary care more accessible and affordable to one and all. Honestly, only a universal healthcare model can provide a sustainable solution through a prudent cross-subsidy approach, whereby poor and deprived population will be provided subsidized medical care with no compromise on quality, and affluent patients will pay a premium for value-added care.

India also needs a more holistic healthcare ecosystem in Tier-II and Tier-III cities to address the lingering issues that prevent the percolation of quality healthcare to these areas. In my view, India can gainfully adopt a brownfield approach to healthcare expansion, such that the bigger hospital chains known for their best-in-class services can pick up strategic stakes in hospitals spread across smaller towns and help in two ways – one, providing quality healthcare to the people of Tier-II and Tier-III areas, thereby eliminating the need for them to visit cities and towns for treatment, and two helping the smaller hospitals scale up in quick time by strengthening their clinical competence and infrastructure.

All the above-mentioned measures will go a long way in raising the quality of India’s medical care, as also ensuring the sustainability of patient outcomes. On the positive side, a few private hospitals in India already match, and even surpass, global benchmarks, but we need a pan-India concerted effort to improve our overall performance as a whole, which alone will ensure a sustainable impact at the end-user level in terms of better treatment and improved quality of life for patients, the most important stakeholders of the healthcare industry.