eHEALTH Bureau

‘Healthcare for all: Global standards with a local touch’ The white paper by Hosmac, in collaboration with Ficci that was launched at Ficci Heal 2010, Delhi, has attempted to emphasise this concept of ‘Healthcare for All’ with reference to a few critical aspects of healthcare delivery.   In the health expenditure pie for India, the government’s share of expenditure is 26%; while 74% of all healthcare expenditure is private. In effect, much of the investment in healthcare is left to market dynamics: private health facilities proliferate where people can pay. The challenge hence is to develop a healthcare delivery system that overcomes this inequity and is available, accessible and affordable to all. There are a few key parameters that drive the output. The key parameters identified are, healthcare infrastructure, healthcare education, manpower, workforce, health insurance, medical equipment. The Ficci Heal report has examined India’s performance within each of these parameters and compared how India fares for these parameters against a fairly representative global sample of countries.India has a very low hospital bed density of 0.9 per thousand people, which is less than one-third the WHO norms of three beds per thousand people. This bed density is the worst among the sample studied. China, despite its larger population has managed creating more than three beds per thousand. India’s ratio is further skewed, if one considers the rural scenario. For e.g. a rural population of 30,000 has a primary health centre of 4-6 beds. Hence the quickest accessible public sector bed is about one for six thousand people. India has the highest number of medical colleges in the sample studied. It, however, has the lowest number of doctors per 1000 populations in the sample, India is in the middle – 5th out of 7 – in the number of nurses per 1000 people, the country also has the lowest no. of care providers – 1.9 per thousand people.Hence availability and provision of adequate and appropriate healthcare is a problem. Medical equipment is a leading cost-driver for healthcare inflation. The research paper has briefly surveyed how the Asian countries, China and Singapore, who like India have been technologically dependant at some stage, have dealt with this.Higher quality standards may drive up the costs of treatment for the local people; however, they are essential if we are to attract global patients for whom these high costs are very affordable thanks to the exchange rate. Sustainable ways to promote traditional holistic local medicine for these global clients, have also been explored. The report, consequently, examines the rationale and challenges for public private partnerships (PPPs) and reviews cases around the country where PPPs have been tried out.

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