Elections are around the corner and as the polls pitch increases, Health Issues India is campaigning to make public health issues a part of the national political narrative. As part of our continuing series health for polls, today we interview Dr Ali Mehdi, Senior Research Fellow at the Indian Council for Research on International Economic Relations.Ques: Despite several government schemes, Indians prefer private hospitals for their healthcare needs as the government-owned primary healthcare infrastructure is in shambles. So, shouldn’t the quality of healthcare be a priority along with access?
Ans: Public health infrastructure is not uniform across India. Its utilisation is the highest for the privileged groups, which means it is not always bad (but comes at a cost). In public facilities like All India Institute of Medical Science (AIIMS), New Delhi, one needs to have contacts to get access. Quality is a concern vis-à-vis private providers as well. Health sector governance and regulation need to be strengthened to tackle quality concerns across the board and lesson can be drawn from the U.S and EU.
Ques: Medical tourism rose by sixteen percent last year even though only 1 doctor is available for over 11,000 Indians. Is quality healthcare only meant for the rich?
Ans: Medical tourists are not necessarily rich – in fact, those from developing countries come here because there are scarce quality health facilities in their own countries and India offers quality care to them at a relatively affordable cost. The Indian government should take a series of steps to raise the quality of care for citizens of its own country. The threshold for minimally acceptable quality should be raised – and be independent of one’s financial status. It has to be seen whether Ayushman Bharat will be able to address the quality gap.
Ques: Can a better public-private partnership reduce this socio-economic gap and increase the penetration of medicines and other facilities?
Ans: The public sector is incapable of addressing the enormous challenges that beset India’s health care on its own. The private sector has to definitely be part of the solution. The question is – what would be a mutually acceptable and sustainable template for a public-private partnership as the primary objectives of the public and the private sector are different
Ques: Bureaucracy plays a crucial role in healthcare accessibility. How can the policymakers curtail red tape to fill up loophole?
Ans: It is important to engage the private sector in a framework of mutual trust and accountability.
Ques: Can the government succeed in becoming a healthcare payer after barely achieving the task of being a healthcare provider?
Ans: It should be a single payer and can aim to be a provider only where it has a competitive advantage over the private sector in terms of access and affordability.
Ques: Is increasing spend on health from only 1.4% of GDP a possible solution?
Ans: Yes. A political will is missing, but healthcare has gained enormous traction since the launch of the National Rural Health Mission in 2005. Things will hopefully improve in the future. The focus has to shift from killing citizens to saving them!