Palliative care, a way to reduce financial distress for people with life limiting diseases

Source: This post has been created based on the article “Palliative care, a way to reduce financial distress for people with life limiting diseases” published in The Hindu on 17^th October 2023.

UPSC Syllabus Topic: GS Paper 2 Social Justice — Issues relating to development and management of Social Sector/Services relating to Health.

News: This article discusses the positives of incorporating palliative care in India’s healthcare ecosystem. It also highlights the challenges in the palliative care sector in India.

What are the implications of the rising cost of healthcare in India?

With only 1.35% of GDP being spent on government health services, patients bear most of the health expenses. Many Indians are either a hospital bill away from poverty or too poor to access healthcare.
It is estimated that nearly 5.5 crore people fall below the poverty line every year due to out-of-pocket healthcare expenditure.

India’s non-communicable disease burden is on the rise. This will push more and more people into poverty as they require lifelong treatment and periodic health check-ups.

This rising cost often leads to bankruptcy, decreased treatment satisfaction, foregoing or delays in seeking further medical care, poor quality of life, and poor survival.

Even if treatment is free in govt hospitals, the cost of travel, purchasing medicines that are out of stock in govt pharmacies, and loss of wages due to the absence from work contribute to the financial burden.

Often assets have to be sold-off and education of children in the family stopped to cope with the financial burden.

What is palliative care?

Palliative care is a branch of medicine that looks at improving the quality of life of those having life-limiting illnesses like cancers, end-stage kidney disease, debilitating brain disorders, complications of diabetes, and heart disease among others.

It focuses on alleviating uncontrolled symptoms of the incurable illnesses mentioned above.

It takes into consideration not just the physical dimension of health but also looks at the social and economic realities of the patient and the family.

Vocational rehabilitation and social reintegration are crucial elements of palliative care.

What are the issues with palliative care in India?

These factors have resulted in poor demand and poor access to palliative care in India:

1) Low awareness levels: regarding palliative care in India, both among healthcare workers and the general public.

2) Currently, palliative care is not covered under most insurance schemes in India.

3) Unplanned and low funding levels has also been a barrier to palliative care services. This prevents long-term planning.

4) Palliative care from primary and secondary health centres is far from being achieved.

5) The private healthcare sector has neglected it.

What should be the way forward?

1) Early initiation of palliative care in patients has been shown to reduce health expenditure by up to 25%. For instance, home-based palliative care can reduce the travelling costs of patients. Hence, palliative care should be incorporated into the Indian healthcare system.

2) Instead of its current mode of occasional annual budgeting, the National Program for Palliative Care must be consistently funded.

3) Palliative care provisions will help in generating goodwill for corporate hospitals, and will also improve the utilisation of beds, and ultimately help corporate hospitals in generating wealth. Private healthcare providers should prioritise it.

India is becoming the “Epicentre for non-communicable diseases”. It is the moral obligation of the health system to take care of people, especially when they are suffering from life-long illnesses.