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Indian Healthcare 2017: A Testing Year

One can only hope that this discontentment and anger with our healthcare system will take a more constructive path in the year ahead

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If would be easy to get pessimistic considering the year 2017 was. But at Apollo, we have always focused on the positive and built a culture on looking for solutions and answers. So let's look at the positives rather than give in to despondency.

The National Health Policy unveiled in 2017 had prevention at its core and this gives clinicians and practitioners a lot of hope. The Centre's Rs. 160,000 crore National Health Assurance Mission which promises more than 50 free drugs, a dozen diagnostic tests and insurance cover to every citizen by 2019 will make healthcare more accessible if implemented properly. It is also a huge positive that the government has launched a population based prevention, screening and control programme for the five main Non-Communicable Diseases (NCDs). In the first phase, the population based screening component will be rolled out in 100 districts in 32 states and UTs with about 1000 sub-centres undertaking screening before March 31st of this year. If this programme can be made sustainable and scalable with greater involvement of the private sector it has the potential to create a healthcare revolution. Early detection is the biggest defense against NCDs.

There can be no mistaking that India's biggest health threat is the tsunami of NCDs that we are staring at. Here is where we need to get real and fast. The statistics are now known to everyone: that NCDs account for 60 percent of deaths in India. That the probability of an Indian, in the age group of 30 to 70 years, dying from one of the four main non-communicable diseases-diabetes, cancer, stroke and respiratory problems-is 26 percent, that there are over 62.8 million diabetics in the country and about 80 million are pre-diabetic. That over 600,000 people in India die each year due to cancer and almost 70 percent are in the 30 to 70 age group. For a moment, forget the statistics. The fact is each one of us today, has a friend or family member who died prematurely due to an NCD.

So as 2017 comes to an end, the truth is inescapable: we remain underinvested in health infrastructure, we have a scarcity of doctors and nurses and are vastly under-insured as a nation.
 
Unfortunately this year, we forgot these very fundamental, structural issues and healthcare was reduced to sensationalism. Hospital providers became everybody's favourite villains and the spotlight remained trained exclusively on malpractices and incidents of neglect. Almost every other day there were instances of violence against doctors / hospital staff. The bond of trust between doctors and patients was broken. Media, governments and civil society failed to appreciate that these are aberrations and that millions of people get cured and treated successfully each day across private hospitals in the country. Even more unfortunate is the fact that these negative instances resulted in knee jerk policy reactions from the state and central government which could make investment in private hospitals very risky at a time, India can least afford it. Indeed, the debate around cost became so one dimensional that sadly clinical outcomes and quality of healthcare took a back seat as did fostering innovation and customer choice while framing policies and measures.

One can only hope that this discontentment and anger with our healthcare system will take a more constructive path in the year ahead. That name-calling will give way to introspection on the part of all participants, solution seeking and fundamental change. Above all as we devise new structures, processes and laws we need to be cognizant that at all times making healthcare affordable and accessible must never be at the cost of quality. Else tragedies like Gorakhpur will be repeated.

Investment in healthcare, both private & public, is badly needed if India is to realize the aspirations of its people and encash its demographic edge. Healthcare has the potential to create millions of jobs and be the next engine of economic growth. This sector is the fifth largest employer in the country and has the potential to generate 7.5 million direct jobs by 2022. Most importantly, it has created 5.2 million direct and indirect jobs and generated USD 1 billion of foreign exchange through medical tourism alone. Sadly, India's potential for Medical Value Tourism remained untapped for yet another year. MVT has encouraged higher forex inflows into the Indian economy for over a decade. While medical tourists were only 6.4% of total tourists, they contributed over 17% of forex earnings in 2015. The growth of MVT has also led the entire health sector to focus on quality and outcomes.

With the right policies, greater focus on public-private partnership, more thrust on innovative ways to increase health coverage and incentives to hospitals to develop data-driven clinical protocols which work for the Indian demographic we can turn around India's health scenario and indeed become Healers to the world because there can be no two opinions on the fact that India has the capability to provide global quality healthcare at a fraction of global costs.

Disclaimer: The views expressed in the article above are those of the authors' and do not necessarily represent or reflect the views of this publishing house. Unless otherwise noted, the author is writing in his/her personal capacity. They are not intended and should not be thought to represent official ideas, attitudes, or policies of any agency or institution.


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Sangita Reddy

The author is Joint Managing Director, Apollo Group

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