The silver lining

The seven hundred odd doctors who have lost their lives to Covid 19 may finally not have been in vain. The Parliamentary standing committee on Health has stated in its report ‘Outbreak of Pandemic Covid-19 and its Management’ that the Government must address the abysmally low public spending on healthcare and raise it from currently near 1% to about 2.5 % of GDP. This has always been the lamentable crux of the problem with healthcare in India. We have preferred to blame and shame private healthcare for not rising up to the occasion and providing free or subsidized treatment to patients in these difficult times. Unfortunately medical resources of the kind needed for treatment of severe covid 19 patients do not come free of cost. But then after all doctors in India are next to God and Gods are expected to perform miracles so why do we need to spend money. They should be able to miraculously create the infrastructure and provide services, drugs and disposables at the wave of a wand and not charge for the same.

In fact during this pandemic the doctors were fleeced by suppliers of oxygen, masks , PPE kits, Remdesivir, sanitizers and other essentials needed to treat Covid 19 patients. Private healthcare which has been blamed ubiquitously has not turned in great profits because what they made up in revenue from covid patients, they lost from non covid elective procedures which were postponed during this period. The bread and butter of earnings of these hospitals from knee transplants, hysterectomies, cholecystectomes, cataract surgery, and so many others simply vanished. Even private clinics took a hit financially because of the covid paranoia. The staff could not be laid off but revenue was cutoff. Many smaller clinics remained closed for 3-4 months and even now have only partially opened.

Medical education is a secure investment and a guaranteed money spinner hence we have 80 member parliaments who have invested in private medical colleges as per a report by Tribune. Do we see our esteemed politicians investing in hospitals ? Even stock market does not prefer the healthcare sector though Pharma is another business altogether. Unfortunately in India it is a crime to profit by providing healthcare but not from pharmaceuticals or from providing medical education.

As per Economic Times, the financial package announced by the Government to tackle the economy hit by the Covid 19 is now 29.87 lac crore. Unfortunately the amount of package for healthcare per se to tackle the pandemic was 15000 crore as reported by livemint. May be our priorities are misplaced. If we valued the lives and health of our citizens we would invest more on developing public healthcare systems rather than indulge in tokenism. Despite the lopsided priority the fact that politicians are today talking about investment in healthcare is a step forward.

We have no idea what is the ”reasonable” cost of any healthcare procedure. The cost of admission of a covid patient in an ICU at PGIMER cannot be compared to that at Fortis or Max. If this comparison is to be made the investment in infrastructure and annual grants at PGIMER would have to be factored into the cost so calculated. We still have the socialist mindset for healthcare which we assume should be on charitable model or public sector.

Covid 19 has if anything exposed the gaping chasm in healthcare between what should ideally be and what exists on ground. Instead of being based on caste permutations, maybe the 2024 elections in India would be on the issue of commitment of political parties to invest in healthcare.

Dr Neeraj Nagpal

Convenor,Medicos Legal Action Group, Managing Director MLAG Indemnity,

Ex President IMA Chandigarh

Director Hope Gastrointestinal Diagnostic Clinic,

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