Health Care Failure is pushing nearly 6.5 crore people each year into poverty: Dr Jayaparaksh Narayan

Hyderabad, June 07, 2023: Health Care Failure is pushing nearly 6.5 crore people each year into poverty. It is a shame that so many people are pushed into poverty because of the costs of health care.  The Round Table discussion on Vision 2030  on how to ensure quality and affordable health for all in Telangana being organized by FTCCI (The Federation of Telangana Chambers of Commerce and Industry is appreciable.  It is a good move for an Industrial Association to come forward and draft a vision document for 2030 on the subject, said Dr. Jayaprakash Narayan, an author of National Health Mission, a retired Bureaucrat and founder of the Loksatta Party.

58 percent of Health Care expenditure is incurred on out-of-pocket costs.  And 90 Indians work in the unorganized sector and not many have access to health insurance. It is generally perceived that private insurance is the solution to healthcare is a weak argument, it is nonsense, he said.  The quality of family health care is a disaster in our country. The mighty nation the USA spends one-third of its GDP on Health care delivery.  But, the USA is not the best in Health care.  It is the worst in rich countries with the high cost and low impact, Dr. Jayapraksh Narayan added.

Speaking further he said Osmania Hospital gets 6000 patients a day, so also Gandhi 4000 and AIIMS (All India Institute of Medical Sciences) in Delhi attracts 12000 patients a day.  There is so much load on the tertiary medical care of our country.  The World’s best tertiary medical care facilities attract no more than 700 people a day.  They should not be overcrowded.  Patients shouldn’t throng specialist hospitals without availing of basic medical facilities.  We must deploy our resources well, he said.

Another important aspect is the deployment of trained healthcare professionals.  3.2 million people are deployed in Health Care in India. Whereas the USA deploys 6.9 million.  For better access to health care, we need to reach at least a 10 million mark.  Similarly, we as a nation spend 1.01% of GSDP, and Telangana less than 1%.  This is lowest in significant economies, he said. Nearly 7000 Medical Doctors have graduated from Telangana and soon it will be 8000 per year.  We have mastered high-end health care and the lowest cost, he said.

Hyderabad does about 200 bypasses and 200 new replacement surgeries every month.  Our success rate is high.  That is why we are performing well in Medical Tourism. Hyderabad and India are emerging as the world hub for overseas healthcare. Nearly one million overseas people are likely to spend 13.8 billion US $ this year on treatment in India and it is likely to go up to 100 billion in the near future, he said and gave few suggestions.  The emphasis must be given to family health care.  It should be patient-centric, he added.

He refused to agree that trained resources are a problem.  Nearly a quarter million doctors are either unemployed or under-employed.  The Government Medical Colleges have to enhance their credibility. They must improve their skill level.  Today government colleges have lost credibility in public.  They are not seen as experts. But that was not the case in the past, he concluded his address.

Dr GVS Murthy, Director of the  Indian Institute of Public Health(IIPH) said we must focus on three fundamental areas in the vision document. In these days of the APPS world, my talk will be an acronym APPS about ensuring quality and affordable health for all in Telangana. He gave six As — Affordability, Accessibility, Acceptability, accountability, audibility, and Adaptability.  The Ps in APPs is Preparedness of Healthcare Systems, Prevention, Partnerships, Patient Centred Care, Population-based, Primary Care, Participatory, and Point of Care Diagnostics.

The primary health care system in Sri Lanka is strong and even their economic turmoil has not fallen and remained strong while tertiary care suffered. Their life expectancy is 5 years ahead of us.  You must put more resources into Basic Healthcare which subsequently reduces the burden of tertiary care.

He spoke about Ss in APPS which include Systems strengthening, Scalable, Subsidising resources, Skill Pool, Seamless Integration, etc, and others

He suggested that all the issues mentioned must be accommodated in the Vision document

Dr Shamanna, Professor, School of Medicine Sciences while giving his keynote address said as per the 5th Round of Health Index ranking by NITI AAYOG, Telangana stands 3rd after Kerala and TN currently. The data from the Department of Health and Family Welfare, Govt of Telangana indicates that in terms of mortality, 27.6% of the total burden in the state is due to communicable, maternal, neonatal, and nutrition, 59.2% due to non-communicable diseases and 13.2% due to injuries of the total disease. He listed various salient achievements such as KCR Kit Scheme, Amma Vodi Scheme, Kanti Velugu, Basti Dawakhana, etc, and others in Health Care in Telangana.

Participating in Media’s vision discussion Mr Karri Sriram, Resident Editor of Deccan Chronicle observed that affordability is the issue of economists and not doctors.  Ideally, there should have been a roundtable meeting with economists.

Speaking further he said that it is very difficult to find people without footwear.  That status is achieved without the government intervening.  If you want to achieve affordable healthcare see that there is minimum or no involvement of politicians and bureaucrats. He gave several scenarios to drive his point.  Eight to ten buildings built in the city are built either by hospitals or pharma, he observed.

We have two kinds of hospitals –government and private hospitals.  Treatment in Government hospitals is free but corrupt and kills you medically.  Whereas in corporate hospitals though save your life but kill you financially. If the government gets involved, the poor will suffer more. You don’t see many politicians and bureaucrats going to government hospitals, he explained

He strongly advocated that growing children must be taught that they can’t pay for their doctor and hospital bills in the future, they will become unaffordable and they must be fit to avoid being hospitalized.  Thereby cultivating healthy living. He said Ayush is medicine without Science.

He suggested that we must be more innovative in our approach to ensure quality and affordable health.  Free medical field free from government intervention. He strongly advocated that the healthcare sector must be privatized totally.

Doctors are often placed on the same pedestal as a god. But in movies, they are portrayed as criminals. Maybe we need a better portrayal of the profession from heroes like Shahrukh and others he suggested.

Soma Shekhar, formerly with Hindu Business Line said the trust we had in government hospitals in the past doesn’t exist now. We can’t take the risk of going to them.  He suggested creating human resources in public-funded healthcare systems.  Increase Doctors, nurses, and paramedics number.  Revamp Primary Health Centres.  The PHCs must be connected to Government Hospitals, he suggested

A senior journalist from Hindi Milpa FM Saleem asked why there is a variance in the cost of medicine.  Why can’t we have uniform rates?  He suggested that the Vision Document must encourage Telemedicine.

Several Aysuh Professionals, representatives of NGOs, and the general public participated.

The day-long meeting which was held on Tuesday was organised by FTCCI Health Committee under the guidance of Shekhar Agarwal, Chairman of the Health Committee