Presentation on India’s health care crisis

Introduction to the crisis• Negligence of Health related issues in the political debates and in the

media. (He gives the example of India’s best news papers- with a creditable record of the coverage of social issues, rarely discussing

health issues.)

• According to major health indicators like immunization of infants, nutrition level in children and women, supplementation of food and its

equity among all, India holds the low position compared to even Sub-Saharan African countries and Conflict ravaged countries like

Afghanistan and Haiti and even from the neighboring South Asian countries like Bangladesh. (UNICEF Report 2012)

Contd.

• The main reason arguemented by Dreze and Sen for this astonishing figure is the

pessimist government policy towards health and very less public expenditure on Health

which is only 1% of total GDP of India, which is also very less in comparison to developed

and even ‘least developed countries’ level.

• India is competent enough on the technological aspect of Health forum but

there is a lack of efficiency and proper organization.

Fragility of the Indian Health crisis

• The private Insurance trap –• Govt. introduced Rashtriya Swasthya Bima Yojana (RSBY) for providing

a health security umbrella to the people but according to Dreze and Sen this scheme has many loopholes, like

• Its not efficient as there is no incentives for healthcare institutes and insurance companies to serve people who are not filling their premium

regularly (as they are BPL families and their premium is covered by Govt.), so there is a ‘screening’ of their clients, leaving out people who

has high health risk (due to poverty).

Contd.• Then the issue of BPL identification is

also contagious, as many people with very low income who earlier come above the poverty line but they miss out on benefits of scheme, and has to spend large amount of income on healthcare making them the new BPL class.

• And as mentioned by “Wall street journal”, this RSBY scheme serves as an opportunity for the insurance companies to market themselves and develop their brand awareness, leading as springboard for the growth in economy private health sector rather than public sector.

Nutrition deprivation and Inadequate Child Care• Nutrition situation in India remains disappointing,

meager than almost anywhere in the world.

• India has moved forward from the disastrous malnutrition cases of marasmus since

independence but still its very bad in comparison to recent neighbor and colonial brother China, whose

malnutrition level is only 4% which is only one tenth of the horrendous figure of democratic India.

• Poor nutrition level in women leads to other deprivation like immature delivery, increase women

mortality rate during delivery, increase in Infant mortality and alleviation of malnourished children.

C o n td .

• In India, there is a negligence of Child Care from the birth till 6 years of age. It is considered that it’s the household responsibility to take care of

children but due to high illiteracy rate, parents are unaware of the proper vaccination and other healthcare facilities.

• Social Involvement is necessary in this case, to enable parents to take of their children in a proper manner, and a direct provision of health

nutrition, pre-school education is required which is somewhat provided ICDS(Integrated Child Development Scheme), but his scheme is also affected by the policy negligence, resource starvation, and political

support.

Silver Lining of the Successful Tamil Nadu Health Care model

• Tamil Nadu commitment towards the free and universal healthcare is commendable.

• Role of Primary Health Centers and Aanganwadis is emphasized here.

• More focus on Public health sector as Private sector playing as subordinate, which is complete opposite to Indian Healthcare model.

• Women representation is more in these healthcare centers, Aanganwadis, pre-school education and is completely run by them.

• PDS is effectively run in the state leading to better rural health and nutrition level.

• Indian healthcare system can learn from this successful model and mistakes done in past, and should not naively believe that by increasing the private care and insurance,

India health status will get better against all the empirical evidences.

• There is a need to go to the basics and make profounder focus on the primary health centers, village level health workers, preventive health measures, etc.

Critique and Observation Complete Polio Eradication

• India overcame huge challenge of eradicating polio, with a strong commitment that matched $ 2 billion allocation over the years to stop polio. Implementing innovative strategies, the programme reaches an incredible 99 per cent coverage in polio campaigns, ensuring every child, even in the remotest corner of the country is protected against polio. This Fact is completely ignored by the writers in their justification of failure India’s Health care policies.

Success in decreasing Fatal diseases risks

• Also there is been a relative success in controlling Tuberculosis risks and treatments by 85% in new patients by the increasing govt. efforts of awareness and supply free medication (DOTS) for it. The last decade has seen a 50% decline in the number of new HIV infections, and there is a constant increase in awareness about the prevention of AIDS.

Proliferation of generic medicines

• - Indian govt. has been fairly successful in the availability and proliferation of generic

medicines especially in rural areas with opening of its ‘Ausadhi Kendra’. It helps

people to get the medicines and drugs in a cheaper rate but quality is maintained.

Indian govt. has been successful in protecting the citizens from the vices of the

international or national branded pharmaceutical companies which normally

enjoys a period of “marketing exclusivity” or monopoly in the absence of resistance by

the government as we see in U.S.

Cynical towards the Private healthcare sector-

• It is observed that this chapter highlights the importance of public sector and reserves the private sector as its subordinate. But

there should be public private partnership for enhancing healthcare services.

• The domestic private sector can best be harnessed to address local health needs in developing countries, for example India’s

Biotech sector which is predominantly private has provided affordable vaccines, and has higher investment on R&D’s for the

cure for various diseases, which is almost negligible in public healthcare sector.

• The Indian population has also reaped significant benefits from the process efficiencies and cost-effective manufacturing of

domestic private firms, resulting in the availability of affordable, indigenously produced biopharmaceuticals.

Thank you!