Dr Sushil Shah , Founder , Metropolis Healthcare

Our goal as a country should be to reach out to smallest of the smallest cities and make healthcare services available to them at affordable rates.

We have come a long way in terms of various advancements in healthcare in India over the last few years. Basic testing and screening is much easier today than before with faster and more accurate results. Most tests are automated, hence there is little scope for error. Yet, despite all the efforts to bring in the most innovative and advanced technologies in healthcare, majority of rural Indians still suffer from insufficient primary and secondary care facilities. Cost of tests and treatments is still higher than what every citizen can afford, making it inaccessible for them. This has mainly been because of lack of qualified doctors and hospitals in Tier-II cities and towns of India, along with lack of health insurance and inadequate healthcare policies of the government. According to health ministry statistics, even the doctor-to-patient ratio for rural India is far below WHO's recommendation. More than 70 percent of total healthcare expenditure is accounted for by the private sector, which has pleasantly emerged as a dynamic force in this industry.

Where the global market is concerned, the cost and strategy of the healthcare industry is changing drastically. Consumers and service providers are moving toward defensive medicine practices, which are mainly driven by the emergence of large-scale chronic and infectious diseases as well as non-communicable diseases. Large number of new market entrants and innovative healthcare approaches to deliver treatments and care are increasing the complexity and competition, and will result in the healthcare industry to become more and more complex in the near future.

On budgetary allocation in healthcare

The health budget this year has made special provisions for elimination of five infectious diseases, strengthening of rural sub-centers, and recruitment of specialist doctors in government hospitals, increased allocation for programs for women and children, and free treatment for the elderly poor. Missing in this list is a mention of increased budgetary support for the prevention, control, and care for non-communicable diseases like cancer, diabetes, hypertension, and heart diseases – the major causes of ill health, disability, and death in the country today.

These diseases do not afflict only urban residents. They are the major causes of death and ill health in rural areas, where incomes are lower, and medical services are more difficult to reach. A small part of this distress could have been addressed through additional budgetary provisions.

On vision for health and family welfare

My vision for the people is to upsurge their life span and improve the quality of life; to provide them with the highest level of physical and mental health, which may lead to a holistic development of their health and wellness.

A number of primary health problems can be solved if we provide effective training and knowledge to the local population about the necessary steps to be taken in order to prevent serious illnesses and the need to detect them at early stages. From the welfare perspective, shortage of doctors is one huge problem, and their unwillingness to work in the rural hinterland is yet another. Generic medicines are highly underrated in our country, and often doctors prescribe the most expensive medicines. Our goal as a country should be to reach out to smallest of the smallest cities and make healthcare services available to them at affordable rates.

On monitoring the quality of private healthcare

Most international and private healthcare service providers, be it hospitals or the diagnostics sector, operate on their own vision and promise to deliver world-class healthcare. A number of these establishments, like Metropolis Healthcare, for example, are accredited by and affiliated with a number of international agencies as a testimony to their quality of practice. In other words, they are self-regulated. As such, quality is not a concern in these areas. Private independent service providers or standalone labs and hospitals that have no ties to a larger chain or corporation may raise concerns. However, the government can address this concern by immediately bringing into effect a regulatory body that can keep a check on the overall standard of treatment and care delivery in the healthcare industry.

On public-private partnership

The inability of the public health sector to provide advanced quality care has forced the poor and deprived sections of the population to seek health services from the private sector, which is often expensive or inaccessible or both. Evidence indicates that in many parts of India, the private sector provides a large volume of health services but with little or no regulation. This is largely because our government is yet to set up appropriate governing and regulatory bodies for quality control.

The private sector is not only India's most unregulated sector but also it is the most potent and untapped sector. To address the inefficiency and inequity in the health system, many state governments have undertaken health sector reforms in collaboration with private players. Improvement in health is the primary objective, with the private companies bringing in the technology and the public sector bringing in subsidies. Incentivizing the private sector to deliver projects on time and within the budget is the perfect solution to make the latest treatments available to poorer classes at affordable rates.

On areas requiring government investment

The government should definitely invest in the infrastructure of the hospitals and provide them with better facilities, for example, the latest diagnosing instruments and tests. We should also invest in a lot of scholarship programs to encourage the youth to enter the health sector. Creating awareness among the younger generation about how the smallest of the smallest cities also require health services as sound health is the primary focus of every nation for consistent economic growth can help propel the cause of quality healthcare for all in the right direction.

On healthcare policy

The current health-insurance debate is stuck in a larger national dispute over whether the government or the private sector has all the answers. But neither the left's persistent hope for a single-payer system, nor the right's all-encompassing belief in the blessings of unfettered markets, represents a likely political outcome – let alone a reasonable policy solution. The most likely compromise has been known for some time, but as the two parties have grown farther apart on everything, especially healthcare, this outcome has been lost. Now, it is slowly re-emerging, piecemeal, and unnoticed.

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