Amid limited healthcare infra, resources must serve Indians

The ‘Heal in India’ initiative may have several positives but being alert on risks is even more important. Cognisance of the impact on the overall approach towards the Indian healthcare model is crucial. While there have been several ‘hits’, the ‘Heal in India’ initiative cuts across the misses that need to be looked at.

Affordability and accessibility are the two key issues in the healthcare sector in India. Almost 2.1 per cent of the GDP is committed to affordability, which is staggering low as compared with the 9.7 per cent in OECD countries. Moreover, more than 50 per cent of healthcare expenses in India are borne by citizens, pushing 55 million poverty-stricken people further down the abyss.

Almost 28 per cent of the urban population has access to 66 per cent of the beds in hospitals, while the remaining 72 per cent has access to only 33 per cent of hospital beds. In the case of the medical fraternity, 67 per cent of doctors are in the cities.

India has two successful models in the West for valuable lessons. One is the insurance-based model in the US and another is the UK’s state-controlled National Health Service (NHS) model.

The Government is doing all to build the medical education base with new colleges, healthcare plans and reforms for a higher output of medical talent. However, this requires a multiplicity of regulatory checks, where merely the cheque-and-fee model should not be the deciding factor.

While Ayushman Bharat Digital Mission (ABDM) and ‘Heal in India’ initiatives aim to streamline the integrated digital health infrastructure, the ever-increasing healthcare needs of the neglected masses are overlooked. For instance, while the innovative thought of building an online repository of healthcare professionals will enable foreign patients to access the best-suited treatment line, this in no way ensures affordable healthcare for their own citizens. Since Covid-19 brought the world to its knees, nations have supported one another with life-saving vaccinations and medical kits. However, the fine line between the import/ export of products and healthcare professionals may have been ignored and taken for granted. The General Agreement on Trade in Services (GATS) in the 1990s also aimed to create a liberal healthcare world, and the results were criticised globally. A similar impact is caused by an overdose of medical tourism. When a country’s limited healthcare resources are exploited or, more precisely, stretched to the utmost to serve the healthcare needs of stakeholders other than its own citizens, it makes a massive dent in the country’s health equity.

India neither has a strong supply side nor a weak demand base that would benefit from such a repository. Instead, a registry is required at the national, urban, and rural levels to address the mounting healthcare challenges, which are manpower, access, affordability, etc. Such a registry along with strong public healthcare initiatives is the urgent need for India’s current healthcare sector. The online National Health Resource Repository (NHRR) being planned and built robustly by the National Health Authority (NHA) will require Health Care Professionals (HCPs) to upload their professional details and achievements along with their preferred destinations. This will give foreigners a ready list of hospitals available for the most appropriate healthcare services. About 42 allied healthcare services that have been on offer via this portal have been identified, offering professionals access to serve foreign patients in the country of their choice.

It is time to prioritize our nation’s healthcare needs and move in the right direction for ‘Heal in India’ first and then ‘Heal by India’.

(The author is an advocate)