Editorial: Digital health ID not a panacea
The larger issues confronting the healthcare sector need a holistic approach and increased public spending
The nationwide launch of the digital health ID for citizens under the Ayushman Bharat Digital Mission is a welcome move as it serves as an online repository of health records but the project should not be seen as a panacea for the woes plaguing the country’s healthcare sector. While the idea is ambitious and the technology being used is robust and time-tested, the larger issues confronting the nation — poor hospital infrastructure, acute shortage of doctors, nursing staff and equipment, pathetic state of affairs of the primary healthcare centres and absence of specialised treatment facilities in rural areas — need a holistic approach and increased public spending. The coronavirus pandemic has exposed the inadequacies and loopholes in India’s health infrastructure, particularly during the destructive second wave in April-May this year. The entire medical edifice almost crumbled as lakhs of cases and thousands of deaths were reported every day. Like education, healthcare is a sector where things cannot be expected to improve overnight. The task is particularly challenging because of the urban-rural divide and the fact that an overwhelming majority of the doctors live and work in cities and towns. India’s expenditure on health as a percentage of GDP is just 1.17%, one of the lowest in the world. In India, the doctor-to-population ratio is 1:1,511 as against the WHO norm of 1:1,000; the nurse-to-population ratio is 1:670, far less than the WHO-prescribed 1:300. The staff shortage is more acute in rural areas, forcing villagers to throng urban centres that are already overburdened.
The country’s woeful healthcare infrastructure is a legacy issue resulting from years of neglect. While the Centre’s digital push is certainly desirable, one must keep in mind that technology alone can’t bring about revolutionary changes in the health sector. Fundamentals must be strong so that an enabling ecosystem can be created seamlessly for adopting any new technology. The goal of setting up one medical college and hospital in every district is still a far cry. It is also essential to bridge the digital divide that is depriving the poor of the benefits of technology-based public services. While telemedicine has emerged in a big way since the outbreak of the pandemic last year, facilitating access to doctors remotely, it cannot, however, replace in-person interaction between the doctor and the patient. The creation of a digital database of citizens’ health records, without first putting in place a data protection law, would lead to adverse consequences. In the absence of an effective oversight mechanism and public awareness, the vast data could be open to misuse. There is also a danger that some unscrupulous business enterprises could use sophisticated algorithms across the health databases to make access to affordable insurance difficult.
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