Dr Nikhil Arbatti
Consultant Minimally Invasive Spine Surgeon,
Nanavati Super Speciality Hospitals

Healthcare Industry: Changing Scenarios And Trends

The healthcare market in India is a mix of individually run hospitals, corporate hospitals, trust run hospitals, and government aided hospitals. All these hospitals cater to a different patient population. Medical insurance provided by private players is not opted by everyone, also the amount availed by everyone is many times not enough to cover majority of medical expenses like bypass surgeries, cancer treatments, and other treatments. Unlike in the United States of America, where insurance is compulsory for all people, here it being optional is not availed by everyone, unless offered by the employer or if taken individually is not of high amount. Thus, a fragmented and very spread out market means there is a scope for every type of medical healthcare provider, if they have adequate facilities and proper doctors.

On budgetary allocation in healthcare

The budgetary allocation is expected to be only Rs 50,000 crore for the entire year of 2018-19. This is way short of the actual required budget allocation for medical healthcare. The expected budget should be a total of Rs 800,000 crore at both central and state levels for providing adequate resources, up from the Rs 200,000 crore now allocated. Thus this shows the huge gap in the actual expenditure and the expected expenditure. This is the reason the up-gradation of government facilities and the establishment of advanced new centers is also not up to the required rate.

Majority of the rural health centers do not have adequate manpower or facilities, this again is due to insufficient budgetary allocation. An increase in the budget will lead to better salaries for healthcare providers, so more people will be willing to join. An increase in the budget means there will be better surroundings and better facilities, this means people will prefer coming to healthcare centers and not go to private setups which may sometimes prove costly for some. The inadequate allocation of budget leads to strain on existing resources due to the ever increasing population of people opting for government resources. Unless the budgetary allocation does not increase, there is always going to be a mismatch between demand and supply.

On monitoring the quality of private healthcare

Due to the fragmentation of the healthcare facilities, the corporate hospitals are spread out and there are no definite markers. The NABH and JCIA accreditation are two accreditation agencies, which have kept a very stringent marker and checks for quality control. Apart from that there is ISO certification, which also gives a standard quality approval. Hospitals if they implement these certification procedures have to go through the same quality checks throughout India, thus the quality can be then compared to be same pan India.

On areas where the government should invest

In a country like India where a significant part of the population lives below the poverty line, it is very imperative to have an effective public healthcare system, which provides affordable, accessible, and quality healthcare services to the lower economic strata. Since it is very difficult for the government to provide and guarantee this aspect pan India, it is imperative to rope in private healthcare providers, who with proper government linked insurance schemes and providing trained personnel can provide such healthcare facilities to all. The corporate hospitals can admit patients in their setup, provide quality healthcare, and also get adequate funding from the government.

Government should invest in more primary healthcare centers, which will provide affordable and accessible healthcare facilities like diagnostics, vaccination, medical drugs, and daycare surgeries. The state government should try to implement its own insurance scheme, which will involve bigger number of citizens, and these schemes can be partially funded by the center in a 60:40 ratio. Thus the entire burden does not fall on the state, and the center can also focus on not just providing monetary assistance but also in setting up standards of excellence institutes; which will provide the necessary workforce.

On equal healthcare standards across the country

The Indian healthcare system is a rapidly evolving space; we not only have a domestic market to cater to but also have international patients coming. We need to make our standards equal across the country, so that the healthcare delivery will be acceptable to all; also it should be transparent and affordable, so that even the lower economic strata population can access it.

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