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Aug04

very high cost on medical expenditure in India, will Government or private Health care reduce it ?



Prof.Dr.Dram,profdrram@gmail.com,Gastro Intestinal,Liver Hiv,Hepatitis and sex diseases expert 7838059592,9434143550


 The Minister of State (Health and Family Welfare), Sh Ashwini Kumar Choubey stated this in a written reply in the Rajya Sabha recently that as per a recently published research paper based on cross-sectional analysis of National Sample Survey Office (NSSO) data, 55 million Indians were pushed into poverty in a single year because of having to fund their own healthcare, and out of this, 38 million fell below the poverty line due to spending on medicines alone.It is true that the total expenditure on out-patient care is significantly higher than the in-patient care. Further, as per the 71st Round (January-June 2014) of the National Sample Survey Office(NSSO) on Health in India, purchase of medicine accounted for around 72% in rural sector, and 68% in urban sector, of the total expenditure on non-hospitalized treatment of ailments and if we add with this indoor or hospitalised expenditure than data are of voluminious expenditure.

                        It is a fact that Medicine is an industry in our country,Government expand less than 1% of GDP on health,in rural sector conditions of primary and sub health centre is alarming,most of the required investigations as keeping pace with modern advancement of medical science,good medicines,infrastructure,staffs are lacking but people are more alerts,need good scientific treatment but it is often not provided so they move towards private sector which is undoubtedly costly and unaffordable to many poors and rural people but they want to have it to get  their live saved and protected so expand everything they have or have loans which make them debted for life.

            In India, due to the influence of private sectors and the induced demand by health insurances in name of reimbursement and cashless payment,Health care has shifted from primary care to secondary or higher levels due to supplier induced demands and moral hazard problems, where excess inappropriate or unnecessary medical care is consumed or utilized.Insurance companies are earning in crores and giving very less but has increased fear in society that medical care is best in private sector and where nobody can afford until there is an insurance so buy insurance and have treatment as per in west,as a part of nexus they pay very high claim to 3-5 star hospitals and very less to small and medium hospitals in rural or town or suburb set up,pay every claim of corporates and almost clearing claim of common people after much enquiry or even court case and Government as administrators of general and health are closing their eye for such blackmailing as are paid hugh bribes.

                       Every now and than such hugh bills are charged in many 3-5 star hospitals that until insurance of corporate or hugh premium present,even middle and upper class cant pay it what to talk of poor people.These hospitals have got modern investigations,treatment modalities and best team of doctors which all has been established by corporate or industrial houses by hugh investments so they have every right to manage their balance sheet and earn but as health is need of all and every wants to save oneself or family members and as service provided by lower and medium hospitals and even government hospitals is not that good so persons in emergency often come there but such inflated bill arise so much resentment and anger against doctors and hospitals as they are often attacked or criticised in media or challenged in court.So it is high time that our Government should share some expenditure or should fix prices of operations,medicines and implants as being done by present government too but due to corruption often benefits is not coming to common people,inspite of government watch dog,common people are paying inflated price as strict actions are not being taken against those who overule government warnings.Cost of many medicines reduced,price of many implants lessened, price of many procedures fixed but still the show go on as no action of defaulters.

        The morbidities and cost per illness episode were inevitably increased in the last decade in India mainly due to supply induced demands. The increase in life expectancy and the demographic change of aged population coupled with chronic diseases will increase the morbidity and health expenditure in the future. Unless the overt reliance on unregulated private sectors is systematically corrected by alternative health financing mechanisms and strengthening the public health system, ‘right to health’ will be a distant dream for a common citizen.Inspite of pushing by government to push forward less costly Ayush Health care ,people donot want to consult them as they took much time and less effective in dealing many emergency and traumatic diseases besides due to corruption,many AYUSH doctors trained in ayush but write only modern medicines as quack and those politicians and bureaucrats who formulate Ayush,never go to them for treatment,all have ones want to get treatment in advanced centre with modern facilitities by specialist doctors.

                      Newly introduced MODI CARE or Ayushman Bharat scheme for poors of 50 crores seem good effort by government but as government has alotted very less budget for health and will start it on the basis of Insurance companies whose intentions and working is always questionable,so many think it is a zumla or simple gimmick for political gain in coming election year for getting votes by making people fool. Government want to succeed it by markedly reducing price of many procedures and treatments by which treatment cant be provided but only many false bills will be generated and real ones will not get the appropriate treatment and facilities as being assumed and advertised by Government.Let us hope for the best if any how if such scheme is successfully implemented than price of treatment in our country will decrease markedly and many poors and unaffordable will get treatment and save their money and family from very high present day cost of treatment in our country.

                         It is high time too for doctors and hospitals,pharma companies,medical health assisting instrument industry  to sit through their various associations on this very much increased cost of treatment as if Government fails due to visible corruptions,than they themselves should come forward to regularise themselves so that cost of getting treatment in our country is reduced and confidance of common people ,media and administrators in medicine is regained otherwise medicine will be an eyesore for all with its open crticism with words like Lutera,Dacoits,Killers etc by society,media and judiciary as such cost are badly affecting all and  killing many who can afford it.

                       Will Ayushman Bharat scheme will be successful ? are as Doctors /Hospitals or Pharma or medical instrument industry think to self regulate yourself to cut cost of treatment in India ?



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