On this doctor’s day, we put forward our heartfelt gratitude to all the doctors and healthcare workers who have been working without differentiating between day and night, without caring about their own lives, to cure us in this challenging time of COVID-19 pandemic. Our words can never equate to your humility, strength, kindness, dedication, and care. Thank you so much; we love you all.
The ranking of India in the world health care index – 145 out of 191 countries in 2018 is disappointing
Though India has shown improvement over the past two decades. A country with a population of 1.38 billion having such a weak health care system could yield catastrophic results in case of widespread infectious diseases leading to epidemic or pandemic
They are causing an immense amount of stress to our healing doctors, caring nurses, supportive healthcare workers, massive life losses, worthless system. So what are the shortcomings in the Indian medical system, and what are the possible solutions?
Shortage of medical personnel and services:
According to an article published by “The Hindu”, the condition of different states is shown below-
|Name of the state||No. of govt. hospital per 1 lakh people||No. of beds per 1 lakh people|
Some states with poorest doctor people ratio:
|Name of the state||number of government allopathic doctors||People served by one Doctor|
Some states with better doctor people ratio:
|Name of the state||number of government allopathic doctors||People served by one Doctor|
These tables clearly show; the lack of resources and put a question mark on the accessibility of resources to the public and functionality of our government hospitals. We can imagine the plight of the system on full load now.
Rural vs. urban bias:
We have two sides of our healthcare system, one is the shining steel and glassy hospitals providing excellent health care to the people living in urban areas, but the scenario is contrary to our rural areas
More than 60% of hospitals, 70% of dispensaries, and 80% of well trained and qualified doctors are found in urban areas.
People living in rural areas are illiterate and impoverished. They even lack the essential amenities needed in life. The private sectors don’t invest in them. The medical infrastructure created by the public sector is mostly run by the unskilled or semi-skilled paramedics and not by a doctor.
In case of a severe ailment, they get referred to territory care hospitals, in the hands of middlemen and health workers who take benefit of their unawareness. Even the readily available medicines become unavailable in rural areas. People die because of delays in the diagnosis of the ailment.
Low investment in the health sector:
According to “Financial Express,” India invested about 1.28% of its GDP in 2017-18. The global Health Expenditure database 2016 of WHO, India ranked 170 out of 188 countries in Domestic general Government health expenditure as a percentage of GDP. In FY-17 Government-funded Rs 37,061 crore, which rose to Rs 65,001 crore in FY-21, further increment to 2.5% of GDP by 2025 has been planned so far.
Research and development is the backbone of any country’s health care system; without it, our healthcare system will stop advancing and eventually collapse. The research and development sector received Rs 1727 crore in FY-19, and in FY-21, it will become Rs 2100 crore.
- If we take a look at other countries’ GDP involvement, we can see the difference in why they provide better healthcare at cheaper rates than India.
Corruption in health care services:
It won’t be shocking to say that corruption and our system are now new normal.
Despite the efforts taken by the Govt to eradicate corruption, it always finds ways to creep in and decay and damage our lives.
Corruption hides beneath the skin of some doctors, Pharmacy companies, pathology centers, and drug retailers. There are plenty of examples when the public is fooled by the physicians regarding their diagnosis and treatment of illness, leading to life losses and money loss.
Doctors ask for a commission of about 30-50% from the pathology centers. Sometimes these people forget that they are serving the country and not merely sitting there for their own pockets.
May God help them know the other ways of making their pockets heavy.
Lack of proper medical education system(govt and private hospital bias
In an interview, Dr. Rajnath Ravella, with “India Today,” revealed what exactly our medical education system needs for its betterment. He said we have 300 medical colleges, and each college produces 100-150 graduates every year, which is 30,000-45,000 doctors. But, to support our massive population, we need 500 medical colleges and nearly 1 million graduates every year. In addition to this, the acceptance rate of CMC Vellore is 0.25%, and AIIMS admits only 72 students out of 80,000-90,000 students who apply for undergraduate courses.
To compensate for the lack of doctors, the Government decided to allow the set up of private medical institutes, but it resulted negatively but and yielded a negative result. The fee for MBBS and other specializations is too high to afford by the middle class, and all they see is money; that is even if you don’t have a required NEET score, but if you have got enough bucks then congrats you are fit to do MBBS and other degrees. Even the degree and the total expense required to get a medical degree offered by Russia and other countries is cheaper than the cost these Private medical colleges demand, so many students are leaving India to pursue their dreams.
“Sujata Rao” India’s health secretary (2009 – 2010) accepted the backdated syllabus and teaching style is also a hindrance to producing good doctors. They are tested based on their memorizing skills and not on any clinical and practical knowledge. Technology and new domains of medical science remain uninvolved.
The professors are chosen based on the number of degrees and not clinical practice; with this, the quality of knowledge is downgraded.
Rising case of violence against doctors:
Needless to say, from the past few years the cases of violence against doctors are rising especially in the state of West Bengal.
Moreover, we got to know enough about such cases amid the Corona crisis in other states. I don’t know how much guts do these people have to beat a doctor; our defense system should invite these people to wrestle with the enemy (not to be taken seriously).
A shout out to all the people Doctors have enough stress; please don’t try to be a noose around their neck. If you feel this much violence, better you seek a counselor and start meditating for your betterment.
Healthcare drains our pocket with the skyrocketed cost of hospitalization and medicines.
Moreover, in private hospitals, patients are fooled and made to stay longer in hospitals. The branded medicines take additional charges. 70% of the Indian population has to pay from their pocket.
Government hospitals provide treatment at no or low costs but most of the people believe that they are ineffective.
Very less and unpopular health care insurance:
The above problem can be solved only if our central/ state Government initiates any health insurance scheme, and also popularize it among the public.
Because generally the people from rural areas are unaware of these schemes and they need it most.
It could help enhance the healthcare quotient of a system by approaching the public with low-cost insurance policies with sizable amounts.
Instead of imposing all on the government, people should know the symptoms of common disease which might help in early diagnosis
Even people living in urban areas are unaware of the symptoms of cancer, heart problems which are common in the world.
There are treatments of certain diseases that are free of any cost. So people need to know about them in order to claim them.
By increasing healthcare spending to 2.5% of GDP. Also, we can use some percentage of our tax to be reserved only for medicare.
Doctors during their training period should be introduced to new technology like Artificial Intelligence and they should be taught about ethics so they stop indulging in unfair ways of earning money.
Strict action must be taken if any medical personnel is found cheating on people.
Policies initiated by the Govt need to be popularized so everyone could take its benefit.
By setting up more Government hospitals and increasing the number of graduates. This will help better the patient-doctor ratio.
To help the rural areas we need to strict the policies which were created by the government, that every graduate would have to serve at least three years in rural areas.
Some of the central government initiatives include-
- This scheme came into existence due to recommendations made by the National Health Policy. Ayushman Bharat Yojana is meant to keep in mind Universal Health Coverage (UHC). Health services in India are mostly segmented, and Ayushman Bharat aims to form them comprehensively. It’s about observing the health sector as a whole and ensuring continuous look after the people of India.
- There are two components associated with Ayushman Bharat: Health and Wellness Centres (HWC) and Pradhan Mantri Jan Arogya Yojana (PM-JAY). 150000 HWCs are created to make sure better healthcare for the people. These HWCs are transformed versions of earlier initiatives like sub-centers and First Health Centres. The PM-JAY is an insurance scheme for the poor. It offers a health cover of Rs. 5 lakhs per family on an annual basis, and therefore the payable premium is Rs. 30.
Aam Aadmi Bima Yojana:
- The Aam Aadmi Bima Yojana (AABY) is for people involved in particular vocations like Carpentry, Fishing, Handloom weaving, etc. There are 48 such defined vocations. Before 2013, there were two policies of comparable nature, AABY and Janashree Bima Yojana (JBY). After 2013, JBY was merged with AABY.
- The premium for Rs.30000 policy is Rs. 200 for a year. The eligibility criteria for this policy is that one should be a family head or an earning member of one’s family (around the poverty line) and will be performing one among the 48 mentioned vocations
Central Government Health Scheme (CGHS):
- As the name suggests, this policy was initiated by India’s Central Government. Central Government employees are eligible for this policy. For instance, Supreme Court judges, Certain Railway Board employees, etc. This policy has been active for six decades and has covered quite 35 lakh employees and pensioners.
- Hospitalization, also as domiciliary care, are covered as per this plan’s terms and conditions. The Central Government insurance Scheme includes Allopathy and Homeopathy also. it’s available in 71 cities, and therefore the project is to expand the scope to more areas.
Employees’ State Insurance Scheme:
- A considerable number of individuals worked in factories post-independence in India. The working conditions were such that there had been injuries and deaths also. This is often where the concept of insurance proved beneficial. Employees’ State Insurance Scheme was launched in 1952 to supply a financial cover just in case of illness, disability, or death faced by insured workers/employees.
- At the initial phase, only Delhi and Kanpur were considered, but the scheme expanded with time. This policy got an upgrade within the year 2015. Now, entirely 7 lakh factories are a neighborhood of this scheme.
Pradhan Mantri Suraksha Bima Yojana:
- This scheme came into existence to supply accident insurance to the people of India. In 2016, it was observed that only 20% of the Indian citizens had an insurance cover. However, Pradhan Mantri Suraksha Bima Yojana aspires to vary this statistic positively.
- People aged 18 to 70 and having a checking account can avail of the advantages of this scheme. This policy offers an annual cover of Rs. 1 lakh for partial disability and Rs. 2 lakhs for total disability/death for a premium of Rs. 12. The bonus gets debited automatically from the insured person’s checking account.
Rashtriya Swasthya Bima Yojana:
- This scheme is directed towards people working within the unorganized sector. Often, they’re not covered under any policy. And in such a scenario, if they fall ill – which happens frequently – their savings get exhausted. Thus, they’re never ready to ensure they need savings within the bank. This is often where insurance can prove helpful to them.
- The Ministry of Labour and Employment launched Rashtriya Swasthya Bima Yojana. Individuals workers within the unorganized sector and below the poverty level are covered under this scheme. The duvet also extends to their family (maximum of 5 members).
Universal insurance Scheme:
- Globally, tons of developed and developing nations have some kind of health care schemes for the advantage of their poor people. In India, the Universal insurance Scheme aspires to try to do that and far more. This scheme is often availed by the poorest of the poor within the age bracket of 5 to 70 years.
- Universal insurance Scheme offers individuals also insurance. It covers hospitalization, accidents, and disabilities. The premium varies as per the dimensions of the family. Those falling under the poverty level got to show proper documentation to avail of the policy.
Some of the state-sponsored health schemes include
- Kerala: Awaz Health Insurance Scheme.
- Rajasthan: Bhamashah Swasthya Bima Yojana.
- Tamilnadu: Chief Minister’s Comprehensive Insurance Scheme.
- Kerala: Karunya Health Scheme.
- Maharashtra: Mahatma Jyotiba Phule Jan Arogya Yojana.
- Gujarat: Mukhyamantri Amrutum Yojana.
- Andhra Pradesh: Dr. YSR Aarogyasri Health Care Trust.
- Telangana: Employees and Journalists Health scheme
- Karnataka: Yeshasvini Health Insurance Scheme.
- West Bengal: West Bengal Health Scheme.
Every system has challenges to be overcome to run smoothly and efficiently. So does our healthcare system.
Planning and implementation are two different things, and our government lacks in implementation of the schemes. Since healthcare, education, and better living conditions are among the top priorities of every Indian.
It becomes essential that these three sectors keep evolving and advancing with time.
There are some easy steps to make situations better if not the best, which needs to be followed like we can be aware of the symptoms of diseases and those free treatments given by the government.
Other steps are not in our hands, but we hope that the government will implement them soon. You can also comment down if you have any solution in your mind. And remember together we can bring a change.