Stepping toward a healthcare revolution

For 67-year-old Jack Rowland, a Californian resident, life was a bed of roses, until a sedentary lifestyle hit him hard. With both knees going stiff, he had no option but to opt for surgery. On inquiring in the nearby hospitals, the estimates left him shell shocked. Why? He was given an estimate of USD 50,000 for just one knee replacement. I do not make that kind of money anymore! I am retired and live on a pension, he said. Facing an option of running huge debts or a life of pain and discomfort, he chose a new path altogether.

He admitted himself as a patient at our hospital and completed both knee replacements for a fraction of the cost estimated in his home country. The entire three-week trip — including flights and lodging was all done in lesser than he had ever imagined. Jack’s story may seem unconventional, but he is not the only one to have visited an Asian country for a medical procedure. After all, it is not a surprise why.

With rich tradition and culture, India, in particular, is amongst the topmost Asian countries when it comes to delivering modern, yet affordable, healthcare. From visa assistance to local interpreters, Wi-Fi and gourmet cuisines, hospitals have gone the extra mile to make international patients feel at home. In the medical fraternity, a well-established fact is that Indian doctors and nurses have earned a reputation for outstanding clinical expertise and bedside manners.

Come to think of it, it is indeed surprising that over a million trained medical practitioners and nurses migrate to foreign lands looking for greener pastures. Moreover, it is widely known that innumerable medical technicians in Australia, the UK, and the Middle-East are of Indian origin. For a country that has vast potential, trained manpower indeed is its greatest strength. The question remains whether this is accounted for in our country’s growth.

If you look at the APAC territory, not so far from home, our Chinese neighbors have well-established themselves as the manufacturing hub of the world in the last two decades. Why cannot we, in turn, establish ourselves as the ‘human resource’ hub – particularly in healthcare? In fact, a country like Thailand boomed at the right time and attracted a number of Westerners with their warm hospitality and patient-friendly policies. They took our crown of medical tourism, the one that surely can be reclaimed. After all, India already has the highest caliber of medical equipment, infrastructure for the growth of telemedicine, and clinical expertise to become the world’s envy.

The other side of the coin is a different story altogether. India faces a rather vast rural-urban divide when it comes to accessible medical facilities. With a dearth of basic healthcare infrastructure in the remote parts of the country, the rural population mostly relies on alternative medicine and government programs in local clinics. Often, these are far from equipped and leave patients in want of better facilities. The monetary situation makes it even worse. Most of them pay for their hospital visits and doctors’ appointments with straight up cash after care and no alternate payment arrangements.

Think of it this way, if an individual spends `100 for their health, a staggering 60 percent of it comes from their own pocket. Such statistics are backed strongly by research. Every year, more than 60 million Indians are pushed into poverty because of medical expenses. Globally, out-of-pocket spending is considered a rather regressive form of finance and India has the worst record when it comes to this trend. We are a country where those who can afford healthcare, do so and those who cannot, end up suffering with misery.

Although the state and central governments run various systems to ensure that the country’s poorest residents are given free treatment, this is far from the truth. Public hospitals are overburdened and deficient, frequently producing stories about patients who suffer from medical malpractices. The solution to this, I believe, is to have a unified health insurance policy applicable to one and all. Thailand, for example, delivers the majority of primary and secondary care in the public healthcare centers and, to a certain extent, tertiary care too. For services that are not available in the public system, especially the tertiary care, financial protection has been extended to the entire population. This has resulted in low out-of-pocket expenditure and better outcomes with low public funds.

India too can work on a similar model. A unified healthcare coverage should include access to primary healthcare that is preventive, promotive, and curative while ensuring people are far from a financial ruin. Besides accessibility, what is equally important is accountability. A private or public insurance company should have the ability to successfully implement a policy of this scale and ensure it actually reaches those who need it the most.

Some of the most recent schemes launched by the government are the Ayushman Bharat and the Pradhan Mantri Jan Arogya Yojana (PMJAY). These policies address access to primary healthcare and financial viability for the poorest of the poor. These could turn out to be the largest successful schemes in the world, if only the implementation is spot on. This automatically translates to the need for a quantum leap in funding. Only then will the best of doctors will have the ability to partake in this initiative. Only then will the best of technology be made available at those set-ups. Only then will healthcare reach each and every individual. Only if we invest more for the long-term health of the nation will there be a proportionate rise in GDP.

This is an incredibly ambitious chance for us to make a difference. There are lots of moving parts, and this thought gives us all – medical providers, private companies, and public system – the impetus to work together to achieve the nation’s goal of ‘health for all.’ Indeed, it presents itself as the perfect opportunity to all stakeholders to re-organize and redefine themselves for the betterment of the nation. Ultimately, a strong healthcare program is imperative to power a country’s economic development. Of course, an increase in GDP alone is not a guarantor for good health. However, an improvement in health does positively relate to GDP since a healthy workforce contributes to better productivity in the long run.

The cost of healthcare or, more appropriately, the cost a nation has to bear to provide healthcare to its citizens, has been one of the most hotly debated issues globally. Closer to home, another fact that sticks out sorely is the matter of budgetary allocations. Did you know that India’s defense allocation this year is `282,733 crore and health allocation is `63,538 crore? This automatically translates to the defense budget being close to five times than that of the health budget. Regardless of how much a country spends on their defense, it cannot guarantee perfect security. I am not saying funding needs to be redirected from the current allocations to healthcare, but surely, we can make health as much of a priority as defense. The fact of the matter is that there will always be choices that have to be made and risks that are bound to be taken.

Is it not more prudent then for a successful budget to fund the nation’s development and healthcare system? After all, no country can be strong enough unless its roots back home are strong. A strong healthcare program is imperative to power a country’s economic development. With a number of novel initiatives underway, the government has already taken the first step backed by data-driven work. But what it definitely needs for better facilities is an investment in human resources, coupled with a bigger budget for healthcare. Then and only then, will we be able to achieve the magnitude we are looking for.

Isn’t this exactly what India as a country achieved with the IT boom? It was in the 90s when the rest of the world perceived India as a backward nation. No one ever thought that we could have the internet bandwidth, the reliability of electrical power, or workplace comfort for IT staff in order to offer global technology services. Fast-forward to today, India’s world-class centers have taken the world by storm. We always had the manpower, all we needed was the right push.

India has and will always be a powerhouse when it comes to healthcare. The production and distribution of some of the world’s most generic drugs for controlling diabetes, heart diseases, and hypertension stem from our country. In fact, the medical industry has seen an overall boom owing to the success of the pharmaceutical industry. Only when we have a congruous public-private partnership will we able to achieve world-class results.

An ocean of opportunities awaits us. What’s left is for us to sail close to the wind.