Healthcare and post-pandemic India: Of trials and tribulations
By Vaibhav Maloo
English churchman and historian Thomas Fuller died at the ripe age of 53, leaving us with a peculiar yet poignant quote that goes something like: Health is not valued until sickness comes. Perhaps he was talking about Indians when he said it because, for the longest time, healthcare only meant immediate treatment to us. Today, however, it is finding a deeper, more responsible connection – the country’s development.
With immense opportunities opening up for investments and development in this sector, India has the potential to become a global healthcare hub. According to a Niti Aayog report, healthcare is fast emerging as one of the largest sectors of the Indian economy in terms of both revenue and employment. Driven by rising income, better awareness, access to insurance, and quality and affordable services, the healthcare market in India is expected to reach Rs 3,72,000 crore (US$ 372 billion) by the end of 2022. To support this, in the Union Budget 2022-23, the Ministry of Health and Family Welfare (MoHFW) was allocated Rs 86,200.65 crore (US$ 11.28 billion). Besides, the Indian government is also planning to introduce a credit incentive programme worth Rs 500 billion (US$ 6.8 billion) to boost the country’s healthcare infrastructure.
The numbers are massive and so is the substantial push from the Government of India as it comes after the urgency created by the COVID-19 pandemic to accelerate a process of change in the healthcare industry boosted by digitisation, innovation and technology. The global crisis has demonstrated that healthcare organisations need to focus on becoming more resilient, agile, and innovative through digitally-enabled and data-backed business models. Due to the havoc wreaked across the globe by the coronavirus, healthcare providers now realise that it is time we move outside the four walls of traditional health systems.
A report titled ‘The Evolving Indian Healthcare Ecosystem: What it means for the real estate sector’ by real estate firm CBRE highlights that India has one of the lowest bed-to-population ratios in the world and will require an additional 1.3 billion sq ft of healthcare space by 2030 to improve the infrastructure disparity. In this light, as healthcare organisations try to bridge key gaps, a more human-centered approach to healthcare is a necessity.
Though the Economic Survey of 2022 highlights that India’s public expenditure on healthcare stood at 2.1 per cent of GDP in 2021-22 against 1.8 per cent in 2020-21 and 1.3 per cent in 2019-20, the industry still faces several challenges when it comes to infrastructure, personnel, technological advancements, affordability and preventive care. At a time when lifestyle disorders are on a rise, technology-backed public and private affordable healthcare is the only way we can face the new pool of diseases.
While India has over 70,000 hospitals, of which over 40 per cent are government hospitals and primary health centers, the growing middle-class population still prefers private hospitals for treatment due to their infrastructure facilities. During the first and second waves of the pandemic, we saw eye-grabbing headlines on how stupendous medical bills from private hospitals burned a hole in people’s tiny pockets. There is little doubt that private healthcare in the country is better than that of public health centres but affordability remains a concern; a seeming lack of knowledge or interest about health insurances is another issue.
In order to alter the landscape of the current Indian healthcare system, there is an urgent need for a public private partnership. An integration of medical knowledge, expertise and digital transformation can help increase accessibility and affordability while creating a safe environment for focusing on preventive care.
In April this year, Mansukh Mandaviya, Union minister of health and family welfare, informed the Rajya Sabha that India’s doctor-population ratio is 1:834, assuming 80 per cent availability of registered allopathic doctors and 5,65,000 Ayurvedic, Unani, Siddha and homeopathic doctors. These figures when put into the current scenario shows us why allopathic doctors and nurses were so overburdened during the first and second waves of the Covid-19 pandemic. This also highlights that interventions are now the need of the hour to bridge this doctor-to-patient gap as given the current trends, the imbalance will only increase in the coming years due to the growing population. Therefore, India needs to train more paramedic professionals to balance the availability-to-requirement ratio.
Access quality healthcare services is a civic right. Although the Centre is working towards this, it is not going to have a larger on-ground impact until these services are also made affordable. Due to lack of basic health insurance facilities, the middle class and the lower income groups spend more than what they earn as they are forced to pay out-of-pocket to access healthcare services. The pandemic has underlined the system’s shortcomings and it is now a collective responsibility to close these gaps.
As for preventive healthcare, in India, there is little to no emphasis on tackling a disease before it happens. The country’s success with polio proves that putting a preventive healthcare system in place is the way forward for addressing a myriad of challenges patients face as they can control the spread of the disease and thereby reduce mortality rate or completely remain safe from these diseases. Awareness is the key to successfully evade any future pandemics.
Several industry giants believe that automation of healthcare services using artificial intelligence and machine learning will significantly contribute to India’s growth as a medical tourism hub. From facilitating better affordability and accessibility to improving the quality of services provided and drug innovation, adopting technology can help develop workable solutions to long-standing healthcare challenges.
Another factor which is important in India’s journey of becoming a healthcare ‘Vishwa Guru’ is digitisation of processes such as telemedicine and online consultation. During the nationwide lockdowns, many hospitals provided online consultation services. This idea emerged as an essential cost-effective strategy in the healthtech ecosystem for bringing the rural and urban closer.
When talking affordability, boosting healthcare financing is in the government’s plan, but it is also an individual responsibility to contribute to making these services better especially in public health centers.
From its side, the Centre is already running a wide-scale healthcare program under the Ayushmaan Bharat scheme that provides access to healthcare services to the vulnerable communities as part of this health insurance fund. To date, over three crore hospital admissions have been done under this scheme, with a total claim value of INR 36,500 million disbursed and over 18 crore cards produced.
That said, even as neighboring countries are extremely dependent on India for better healthcare services, the journey towards becoming a global healthcare hub is a long road with a clear vision ahead.
(The author is Managing Director, Enso Group. Views expressed are personal and do not reflect the official position or policy of FinancialExpress.com.)