Health sector in India
• • • India has 48 doctors per 100,000 persons which is fewer than in developed nations Wide urban-rural gap in the availability of medical services: Inequity Poor facilities even in large Government institutions compared to corporate hospitals (Lack of funds, poor management, political and bureaucratic interference, lack of leadership in medical community)
• • • • • • • Expenditure on health by the Government continues to be low. It is not viewed as an investment but rather as a dead loss! States under financial constraints cut expenditure on health Growth in national income by itself is not enough, if the benefits do not manifest themselves in the form of more food, better access to health and education: Amartyo K Sen Private practitioners and hospitals major providers of health care in India Practitioners of alternate systems of medicine also play a major role Concerns regarding ethics, medical negligence, commercialization of medicine, and incompetence Increasing cost of medical care and threat to healthy doctor patient relationship
Current Trends in Health Sector
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Govt. Initiatives. The private sector takes the lead Involvement of health insurance Standardization – need for uniformities Manpower: Reversing the Brain Drain Technology takes centre stage The Empowered Indian Patient Public Private Partnership (Ex-Gujarat Govt.) Medical value travel (the hype and the reality) SEZ (The Hidden Opportunity) Infusion of Private Equity: An unmistakable sign of Growth
• All India institute of medical science (AIIMS), New Delhi. • Apollo Hospital, Chennai • Christian medical college, Vellore • Lilavati hospital, Mumbai • Sankar Netralaya, Chennai • Jaslok hospital, Mumbai • L.V. Prasad Eye institute, Hyderabad • PGIMER ,Chandigarh • Wockhardt hospitals limited • Fortis healthcare
A day in hospital:
India is very well placed to tap the growing potential of the healthcare sector. It has the relevant skill-sets with adequate human resources to become the preferred healthcare player in emerging countries across the globe. Increasing urbanization, superior demographics, better health consciousness and higher life expectancy has enhanced the demand for quality healthcare. Lower delivery cost. World class facilities. Rising number of uninsured in Developed countries. Holistic approach-Homeopathic, Allopathic, Ayurvedic.
Cost of Key HealthCare Procedures
Currency: USD Cardiac surgery Bone marrow transplant Liver transplant Orthopaedic surgery
Source: IBEF Research
US 50,000 62,500 500,000 16,000
Thailand 14,250 62,500 75,000 6,900
India 4,000 30,000 45,000 4,500
India healthcare cost-% of US 12.5 13.33 11.11 3.56
Increasing cost of curative medical services. High tech curative services not free even in government hospitals. Limited health benefits to employees. Health insurance expensive. Curative health services not accessible to rural populations. Inadequate availability of skilled doctors and staffs. Limited number of quality medical institutions. Lack of R & D.
Healthcare industry is the world's largest industry with total revenues of approx US$ 2.8 Trillion (2005). India's high population makes it an important player in the Healthcare Industry. According to the IRDA, the Indian healthcare industry has the potential to show the same exponential growth that the software industry showed in the past decade. With increasing number of non-insured population in western countries and increasing healthcare expenditure to GDP resulting in people to opt for treatment options out side their country. Medical Tourism in India will be one of the major sources for foreign exchange. Gradual corporatisation during the last decade. Direct Investments (FDI) has been allowed in this sector with automatic approval up to 51%. FDI is going to be allowed in health insurance within 12 to 18 months.
In India, 80% of the healthcare expenditure is borne by the patients and that borne by the state is 12%. The expenditure covered by insurance claims is 3%. As a result, the price sensitivity is quite high and the high-level healthcare facilities are not in the reach of patients. Poor public infrastructure. Inflation. Medico legal jurisdictions. Country specific restrictions. Organ trafficking. Require equipments is too high in cost.
Existing infrastructure for health care needs to be strengthened. Education, safe water and sanitation need priority. Vaccination coverage to be improved in rural areas. Educating rural people to choose science over superstitution. Better implementation of national health programs. Judicious use of the scant resources by promoting most cost-effective strategies for disease prevention. The challenge of caring for a billion. Promoting healthy life style from early life is a ‘no cost’ intervention which needs to be incorporated in school curricula. There is need for increasing public awareness of the benefits of healthy life style.