A fully functional healthcare system is essential for the prosperity of the individual, families, states and the country.
In order to achieve this in India, there needs to be a focus on four keys areas to improve the outlook. These are:
- universal access
- fair distribution of financial costs for access and fair distribution of burden in rationing care and capacity
- improving the quality of care attention to vulnerable groups such as; women, children, disabled and the aged
In 2000, the World Health Organization Report ranking the health systems put India 112 out of 190 countries. A country with a similar size and complexity is China (ranking 144), between 1994 and 2004, real per capita gross domestic product (GDP) for China and India grew at an average annual rate of 7.8 percent and 4.4 percent, respectively.
Both countries faced similar external forces that challenge their health care systems. Major income growth has created new consumer expectations and demands for higher-quality services and advanced technology.
An aging population accompanied by an epidemiological transition necessitates restructuring the health care system to fund and provide care for a population increasingly affected by non-communicable diseases. At the same time, an ever-widening socioeconomic gap between high- and low-income households poses challenges to achieving the societal goal of equal health status and access to health care.
Existing evidence shows that both countries have experienced major increases in health spending over the course of the past two decades, although China’s appears to have increased at a slightly faster rate than India’s.
From 1988 to 2002, China’s total health spending as a share of GDP increased from 3.3 percent to nearly 5.5 percent, while India’s increased from about 3.5 percent to 5.0 percent over roughly the same period.
Although China and India have made improvements in outcome indicators such as life expectancy and infant mortality, major challenges still exist, in the form of disparities in health outcomes, unaffordable and unequal access to care, household impoverishment due to medical expenses, and rapid health spending growth.
For primary health care, the Indian government spends only about 30% of the country’s total healthcare budget. This is just a fraction of what the US and the UK spend every year.
One way to solve this problem is to address the infrastructure issue by standardizing diagnostic procedures, building rural clinics, and developing streamlined health IT systems, and improving efficiency. The need for skilled medical graduates continues to grow, especially in rural areas, which fail to attract new graduates because of financial reasons.
In terms of areas of focus- the following areas need addressing to move to the next level:
There are wide gaps between the rural and urban populations. A staggering 70% of the population still lives in rural areas and has no or limited access to hospitals and clinics. In addition, the rural population mostly relies on alternative medicine and government programs in rural health clinics.
- India’s healthcare landscape accounts for approx 70% of high out-of-pocket expenditure. As most patients have to pay directly for hospital visits and doctors’ appointments with 5% covered by health insurance policies. This has led to a nascent health insurance market that is mostly unaffordable to rural groups.
- Need to fix its basic health concerns in the areas of HIV, malaria, tuberculosis, and diarrhea. Moreover, only a small percentage of the population has access to quality sanitation, something that further exacerbates the issues.
- The growth of the Pharmaceutical sector through active research and development and in medical devices.
- Development of an effective regulatory strategy to ensure patient safety as well as ensuring the regulatory pathway is clearly defined.
After many years of underfunding, there are planned sizable increases in investment in health. It is essential that the poor and rural populations are addressed as being disadvantaged in obtaining access to health care and face major financial risk in the event of illness.
In addition, there needs to be a systematic policy for reducing inefficiencies in service provision and managing health spending inflation- a fundamental cause of unaffordable health care and heavy financial risk.
Money alone will not be sufficient to deliver effectively, high-quality care these need to be added to with infrastructural support to deliver an improvement in the healthcare system for tomorrow and our future.