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Move into the digital space and allow rural India and semi-urban India to benefit

The healthcare market in India is slated to grow, and growth will be seen for many reasons, both in the government and the private healthcare space. Some of the reasons include a strong government conviction to enlarge the scope of healthcare particularly in the rural areas and the Ayushman Bharat scheme. With the economy of the nation improving, the need for improving healthcare as one of the drivers of economy as well as the health of the nation, is a strong focus; and the huge burden of non-communicable diseases is another reason why healthcare will have a major push both from the government and the private healthcare players.

Budgetary allocation in healthcare. This has been a problem and a bone of contention between private and public healthcare players. Over the last three years, the budgetary allocations have been around 1.15 percent of the GDP, and this amount is far below the GDP related healthcare spending of many countries, (Canada:11.6%, America:8%, and France and Germany:11.3%).

Therefore, there is a need for us to enhance the amount that the government puts in and you will notice that even in India, in the last few years, the private enterprise has invested more in health than the government has. I do believe that this will also change with the government’s conviction to put in more, but one has to wait and see.
My vision for health in this country is to move into the digital space and allow rural India and semi-urban India to benefit, particularly in the primary healthcare area. This is the only way of bridging the gap between the service providers and people. It is very difficult to move the service providers to where the people are.

Substantial forward movement has happened this year in this space and it would be interesting to see how this space changes in the coming months and years to benefit India, particularly in the rural areas. While I have specified rural but I would also like to state that this is also the case for urban India and there will be a shift using technology to benefit society and people. There will be higher efficiency, easier access, and lesser costs involved in this whole process.

Challenges you faced while implementing health services. The government has been much more open to private healthcare investments over this last decade and insurance has grown. There have been significant problems in the absence of skilled manpower, attrition of nurses, high cost of acquisition of land and cost of building hospitals with certain standards.

There has not been enough monitoring in terms of quality of healthcare, both in the private as well as in the public space. This is a requirement and standardization is a must.

Regulation in India has always been faced with problems of inefficiency and creating roadblocks that prevents adequate delivery. Therefore, it is important that the kind of regulation that evolves is based on much more self-regulation rather than directed regulation.

Also, transparency and accountability is still lacking in the Indian healthcare space. Equally, for the private healthcare space, this accountability will give better exposure to international markets particularly of the west and other developed countries who still hesitate in using Indian healthcare because they are not sure of the standards and accountability.

PPP. It is vital and has long been since we attempted to do this and the trust deficit between the two major players has fortunately been narrowing especially with this pandemic. One hopes that this will be the way of the future with equal participation and trust on both sides the government is best-off playing the role of the payer rather than the provider.

Also, the fact that healthcare is a state subject does lead to fragmentation of regulation, laws, as well as roadblocks in certain ways. I really wish that there is a move to centralize healthcare because the benefits of this centralization will be enormous.

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