[Answered] “Access to affordable, quality health care is still a dream in many pockets in India.” Discuss.

Access to healthcare in India is poor. The Lancet in its latest study ranked India at 145th among 195 countries in terms of quality and accessibility of healthcare, behind its neighbours China, Bangladesh, Sri Lanka and Bhutan.

Issue of unaccessible quality healthcare services in India:

1. India suffers from lack of doctors and clinics, especially in rural areas and in case of epidemics and diseases like tuberculosis. Thus patients are either never diagnosed or diagnosed too late.
2. The large number of people still living below the poverty line in India. Thus the affordability of quality healthcare is a problem and needs to be addressed.
3. Weak economy, high unemployment rates, and limited economic resources lead to inability to pay and unaffordable healthcare system.
4. Cultural differences such as social, cultural, and linguistic barriers may prevent patients from accessing care. E.g. minorities may face discrimination in accessing quality health services.
5. Environmental challenges, which include unsafe streets; asthma exacerbated by air pollution, leading to unnecessary hospitalisation; environmental allergens causing symptoms that may result in inappropriate testing; and minimal or no spaces for physical activity or exercise; all add to cost of the health services.

How to ensure quality health services to all?

1. Capping price of devices hurt medical industry. To increase affordability of devices, the government should adopt an effective pricing model i.e. trade margin rationalisation (TMR). TMR imposes a cap on the margins across the value chain, rather than capping price of devices.
2. An increased focus on a well-implemented plan for quality control is critical at this juncture.
3. There is a need to co-opt experts, who will carry out a fair and accurate assessment of the true cost of a delivery. This should take into account requirements of minimum quality as well as best lower prices.
4. It is important that all the stakeholders across the value-chain should be involved, and more scientific approaches such as differential pricing for innovative medical technologies should be adopted.
5. The government should focus on healthcare financing, particularly for the part of population that cannot afford healthcare. Launching the National Health Protection Scheme (NHPS) is a step in the right direction. However, the success of the scheme will depend on how well it is detailed out, and implemented on the ground.
6. Efforts should be made to encourage and incentivise wellness/preventive care and making primary care (including basic diagnostic tests and outpatient care) accessible and affordable for all. This will not only improve the overall health of the population, but also free up resources and reduce the overall cost to the exchequer.
7. Technology can play a significant role in managing population health. Big data analytics and artificial intelligence (AI) can help us in the areas of risk identification, disease prevention and early diagnosis, and the government must use these for public health purposes.

With the rise in awareness, affordability continues to be one of the key needs of the country. We need innovative technology solutions for India’s healthcare requirements and the government’s increased focus on the healthcare sector. The next few years are important to tackle its long-standing healthcare issues, and at the same time, adapt to meet the ever evolving healthcare needs of its citizens.