Editorial: Step up healthcare spending

India’s expenditure on healthcare accounts for just over 1.17% of the GDP, one of the lowest in the world. It also has one of the lowest health workforce in the world. The coronavirus pandemic has exposed the gaps in the country’s healthcare infrastructure and should ideally serve as a wake-up call to revamp the sector […]

India’s expenditure on healthcare accounts for just over 1.17% of the GDP, one of the lowest in the world. It also has one of the lowest health workforce in the world. The coronavirus pandemic has exposed the gaps in the country’s healthcare infrastructure and should ideally serve as a wake-up call to revamp the sector on a mission mode. In this backdrop, Prime Minister Narendra Modi’s announcement about augmenting the number of doctors and medical facilities is a welcome development. However, even a cursory look at the present state of affairs on the ground doesn’t evoke much optimism. While Modi spoke about adding a record number of doctors in the coming ten years and establishing a medical college in every district, the Centre’s track record in terms of fulfilling the earlier promises has been far from encouraging. The National Health Policy, approved in 2017, commits to spending 2.5% of the GDP on healthcare but that is not enough. We need more doctors, better infrastructure, pharma companies must be monitored for prices of drugs, insurance coverage needs to be broadened and hospitals need to be more accountable. Over the years, the public health spend in terms of percentage to the GDP has not moved much despite increasing overall allocation for the Ministry of Health and Family Welfare. The Economic Survey 2020-21 admitted that India ranked 179 among 189 countries in terms of prioritising healthcare in the government Budget. Poor public spending on healthcare is a key hurdle in the fight against infectious diseases.

On the state of affairs in government hospitals, the less said the better. They employ only about 1 lakh doctors out of about 9 lakh registered professionals in the country. It is no surprise that the medical staff are often overworked, underpaid, slogging it out in poor conditions and shoddy infrastructure. People have no choice but to turn to private establishments. In India, it is estimated that a visit to the hospital pushes 5.5 crore of people below the poverty line every year. Private out-of-pocket expenses dominate the cost, medicines are exorbitant and insurance penetration is very low. There is no financial support and often the patient’s loss of income compounds the problem. The disproportionate concentration of doctors and specialists in urban areas adds to the woes of the ailing masses. Almost every other patient is vying for care and attention at a select few hospitals in big cities, overburdening the doctors. It is a fertile ground for malpractices. On the other hand, facilities in remote areas lack both manpower and infrastructural resources. The authorities must figure out a way to ensure that the doctors graduating from government medical colleges — that provide education for a pittance compared with the costs involved — mandatorily serve in rural areas for a minimum prescribed period.

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