It is often said that a crisis is too precious an opportunity to be wasted. The current Coronavirus pandemic is not only a global health crisis, but also the biggest challenge the world has faced since the World War II in terms of loss of lives and livelihoods, disruption of economies, and the sheer scale of the spread. Other global events that we have seen in our lifetime, from Cold War to 9/11, pale in comparison to the scariness of this pandemic.
This pandemic has brought many things, previously obscured from public attention, to the forefront. Warren Buffett has famously commented; only when the tide goes out, do you discover who has been swimming naked. Foremost among those exposed swimmers has been healthcare in India. It has suffered from a chronic lack of focus, poor spending levels of the government on health as reflected by being a measly 1.28 percent of GDP, and the lack of concern by the common public, which tends to view health expenditures as wasteful extravaganza.
To add to the misery, most of the health care professionals are poorly paid, struggling with misplaced vigilantism, mob violence and activism of consumer courts. This as number of posts across all hospitals lie vacant even as the doctor-to-patient ratio remains at one doctor for every 1,445 Indians, lower than the WHO's prescribed norm of one doctor for 1,000 people. Until the time the government and the citizens value human health and well-being as their foremost priority, things shall not substantially change.
This is where this crisis presents a unique opportunity to proactively focus the attention of the government, media, policy makers and the common public on this critical issue. The cure should start with budgetary support, which requires to be enhanced to 6 to 7 percent of GDP on health for the next decade. To amplify, in initial years to cover the stark gap, it should exceed 5 percent, and thereafter remain at minimum 5 percent. Certain percentage of this budget should be earmarked towards providing interest free loans and other support to set up quality private hospitals across the country.
The nation should implement compulsory health insurance for all, and comprehensively revise the Ayushman Bharat Yojna, which in the present format is a cruel joke to healthcare providers and the patients. It is saddled with incorrect policies and poor implementation, in spite of being a positive initiative in spirit. In the revised form, 20 percent of beds of all private hospitals receiving government support should admit patients from Ayushman Bharat Yojna. Concurrently, the vacant medical posts to be filled up with adequate remuneration, while employing doctors from various specialities on a contractual basis across district, sub-divisional and PHC hospitals depending on their posting preferences. India must make every healthcare worker feel wanted and cared for.
The next logical step is the creation of an Indian health services, staffed and headed by health professionals and not a generalist bureaucracy. The policy framework, execution guidelines must be conceived, implemented and delivered by the healthcare specialists. Simultaneously, the government should introduce compulsory health insurance (private or government) for all citizens. Proliferation of health insurance shall minimise the prohibitive expenditure by private citizens on health emergencies.
Another legislative initiative needs to be enacting permanent legislation against any form of violence on the healthcare providers, and not only a temporary legislation during the current pandemic. To complete the loop, the government should remove healthcare from the ambit of consumer courts. This may be substituted by an alternate mechanism comprising of health experts who shall first make preliminary enquiry following which the aggrieved litigant may approach higher judiciary, right up to the Supreme Court.
The roadmap is apparent, but it is for the government to embrace it. A diseased or feeble population cannot take India forward to its deserved place in the comity of nations. This is the right opportunity to act and execute transformational changes in the healthcare sector of India. A crisis may be precious but the human lives are priceless.
(The writer is Medical Professional practising at Begusarai in Bihar)