Health care system in India

• NITI Aayog document – ‘Investment Opportunities in India’s Healthcare Sector’

 Promotes further privatisation of health care
 Explores the pandemic as business opportunity for the health “industry” to grow.
• Author – Importance of public health and an enhanced government role in
health delivery services.
• Story of 2 states (model) Kerala and Maharashtra comparison
 Both are big states – comparable state GDPs
 Kerala COVID mortality – 0.48%
 Maharashtra COVID mortality – 2%.
 Reasons
 Huge differences in the effectiveness of public health systems
 Kerala has more government doctors compared to Maharashtra
 Kerala also has a higher proportion of government hospital beds
 Kerala allocates over one and half times higher funds on public health every year in per capita terms compared to Maharashtra.
 Weak public health system has proved to be a critical deficiency
 Clear message: a neglect of public health systems means large-scale, avoidable losses of lives.

Lacunae in the health care system

1. Resource allocation
2. • Central vista project – ₹20,000 crores
3. • Could be utilised for setting up oxygen plants,
   numerous lives would have been saved.
4. • Paltry allocation for National Urban health
5. • Last time allocation – Rs. 1000 crores (amounts to Rs 2 per individual per month)
6. • Parliamentary Standing Committee – Suggested
   allocating ₹1.6 lakh crores for public health during the current year (almost doubling of the present central health Budget)

2.To regulate the private players in health sector

• High Pricing
 COVID-19 care often costs ₹1 lakh to ₹3 lakh per week in large private hospitals
 Massive hospital bills – untold distress even among the middle class.

• Unregulated drug use
 Eg. Drug Remidesvir was used in COVID patients without valid evidence on
efficacy
 Indiscriminate use of steroids culminated

• Mucormycosis infections

• Effective implementation of Clinical Establishments (Registration and Regulation)
Act
 Only 11 states have implemented it
 Not effectively implemented due to a major
delay in notification of central minimum
standards, and failure to develop the central framework for regulation of rates.

• In essence : Need to regulate the private
hospitals. And invest more in the public health