Karnataka is going through a sea of change in the medical sector. Good or bad? Time for a discussion.

Part 1.
There are 45 medical colleges affiliated to rguhs, and around 5 more without affiliation. Approximately 15 are government run medical colleges and the rest are all by private managements.
After writing the entrance for mbbs, 20% of the eligible candidates get into the government medical colleges and the rest all enter the private sector. The fees in these private medical colleges is again regulated by a body formed with the government and that fees is in no way approachable for a decently earning human being, ranging from 7 to 20 lakhs per annum.
So if the regulation for pricing is done, no private medical college can run nor get admissions in future. The blackest of black money can't help sustain a medical college which can't get enough to even pay the salaries of the workers.
One smooth wave of the KPME act amendment and all private medical colleges are almost closed.

Part 2.
Nowhere in this world is experience not respected. Whether the doctor has practised for 2 years or for 20, if he has to charge the same, what respect is given for all the skills and work put in to learn and upgrade? Suppose, a similar condition is seen in the government sector. Will the professor and head of a department not be paid more than a newbie assistant professor? Why should that be done in the government then? Let the salaries be the same for the tutor who has just come out of college and the 30 years experienced professor. Will that be ideal?

Part 3.
Policing. Putting fear into the minds of the doctors. Imagine. Albert comes to the hospital with stomach ache. He has been continuously vomiting and is very much in distress. He needs emergency care. The doctor is seeing another patient and request Albert to wait for a minute. Albert obliges. The doctor, after examining Albert, immediately puts some fluids to stabilise him, then gets an ultrasound scan and blood tests done, identifies it as being probably appendicitis, advises surgery. On opening the abdomen, he finds that the appendix was normal, but it's a case of infection, clears the infection and winds it up. Albert is explained that it was not a case of appendicitis, the actual cause was different and Albert goes home happy.
Come to post KPME act amendment 2017.
Albert enters the hospital with severe stomach ache and recurrent vomiting and enters the hospital in acute distress. The doctor is seeing another patient and requests Albert to wait for a minute. Albert threatens to complain against the doctor if he doesn't see him immediately. The case being examined also threatens the doctor that he would also complain if Albert was seen before finishing his treatment. Fight erupts and doctor gets hit. Somehow, doctor regains his composure and manages both cases, diagnoses after ultrasound and blood tests that it may be a case of appendicitis. Is about to advise surgery, but thinks twice. In case the diagnosis is wrong? So asks for a CT scan for more evaluation. Inconclusive. Then asks for an MRI. Inconclusive. Ultimately decides to open the abdomen. Alas. Appendix is normal. Infection inside. Now what to do?
The doctor relieves the infection and winds it up. Albert is enlightened that his appendix was normal, abdomen was infected and now he is ok. Gives him a bill of twenty five thousand.
Albert is not happy. How dare the doctor say his appendix was normal? Let's teach him a lesson. He just walks into the nearest panchayat office and complains. Wrong diagnosis. Misled by the doctor. Needs compensation.
The doctor is liable for up to 5 lakhs compensation. And that too not in a court. No lawyer to help. In a panchayat office governed by an IAS officer.
Next case of pain abdomen and vomiting? The doctor will just refer him elsewhere. Next case of headache and vomiting? Refer him. Another case of back pain? Refer him. Ultimately, quit profession or leave Karnataka for a more sane place to work.

Part 4:
Labour act implies skilled Labour to be paid Rs.14,000/- and unskilled labourers to be paid Rs. 11,000/- approximately. A clinic requires one nurse(skilled) one sweeper(unskilled) and one compounder(unskilled). Just the wages to these 3 will come to around Rs.36,000/- per month. And this holds good even in the villages.
To make Rs.36,000/- per month, a doctor who is supposed to charge only Rs.50/- per patient will have to see a minimum 24 cases per day. That is just to feed the workers.
Now, a 20 bedded basic nursing home. 5 nurses, 2 sweepers, 2 wardboys and additionally a lab and an xray unit. The consultation amount is Rs.100/- as it's in a town. But the burden on the wages doesn't change. Runs to a lakh plus. So how many patients should the doctor see then? 100 per day???
Let's not delve into the multi specialty kinds. The numbers don't even fit into a calculator.
What's the future? Downsizing. The nurse will be taken out from the clinic. Only the unskilled kinds will be retained. Wardboys will have to double as sweepers. Labs and xray will close in small clinics and nursing homes.
Unemployment in the medical sector would increase a hundred fold. The people who were happily leading their lives would now be made poor. And then would become eligible for all the things the government has fancied for the poor.
A small sweep of the KPME act amendment and the whole medical sector crashes.