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Why is quality healthcare so costly in India? How we can make it affordable

India has come a long way in making a mark as one of the top destinations for medical tourism in the world! Medical tourists from all over are seeking elective as well as life-saving treatments in Indian private healthcare sector at affordable costs! Medical tourism is rapidly evolving into a billion dollar market in India. In fact, by 2020, it is predicted that the country will earn about $7-8 billion annually from medical tourism!

Why then, is healthcare so expensive to those of us living in the country? It has become increasingly unaffordable over the past decade. The costs of healthcare services too vary immensely across different Indian states. The proportion of population opting for private hospitals has increased in recent years as quality of services provided in public hospitals have become questionable. Out-of-pocket expenses spent over healthcare is one of the prime reasons that pushes families to poverty.

So, what really are the real problems in the Indian healthcare sector that is making healthcare so costly in India?

1.​ Shortage of health workers

India has a huge dearth of healthcare practitioners that do not meet up to the required number per 1 lac population. There is less than 1 specialist per 1 lakh population (0.42 as per recent research), which cannot keep up with the ever-increasing demand in the country. It is not uncommon to find poorly trained general practitioners handling cases that need to be looked at by specialists! With more demand than availability of manpower, the costs are bound to be on the higher side!

2.​ Shortage of medical colleges and facilities

With more than 370 medical colleges in the country, India still cannot meet the demand of healthcare service where quality doctors are concerned. Quality medical colleges and universities imparting excellent medical education is in acute shortage in the country. The high demand cannot be met without the involvement of private sector, which makes medical training all the more expensive for the general population. Additionally, the number of seats available for specialization too is alarmingly low! Medical education in the country is laced with corruption and under the table fees in the form of donations. Lack of qualified staff and infrastructure too cuts down seats in colleges adding to major shortage of healthcare professionals in the country.

3.​ Poor quality of government hospitals

The sorry state of government hospitals in India is not unheard of! More than half the country rejects government run hospitals owing to poor state of hygiene, long waiting time, lack of beds and sad quality of care. Rural India suffers the most between the extremely pricey private healthcare and poor quality of public healthcare. The healthcare workers in government hospitals are overworked paying little to no attention to the huge inflow of patients. The density of government hospitals too is very less compared to the population that needs to be taken care. As a result, rural Indians suffer as healthcare is far from home and not easily accessible.

4.​ Faulty government insurance schemes

In India, the concept of insuring health and making use of government schemes is still at a nascent stage. Healthcare is a huge out-of-pocket expense for most households leading to loss of quite a significant chunk of savings to illness! On the other hand, in most other countries, healthcare expenditure is minimal or practically ‘free’! In India, people do not save money or insure themselves for a health crisis either due to lack of knowledge or plain ignorance. Many government run insurance schemes for the underprivileged cover only hospital admissions and not outpatient care while outpatient care is equally expensive given the consultation fees, medicines and tests and scans that the doctor prescribes.

5.​ Malpractices and irregular billing

With overburdened government hospitals at the fore, most patients turn towards private hospitals for healthcare. Private sector healthcare is mostly unregulated with corruption and malpractices rampant. Lack of transparency, referral system between doctors and diagnostic centers, overcharging for treatments, elongated hospital admissions and even more serious medical crimes are a big price that citizens pay when opting for care at private hospitals.

The list of reasons is actually longer and many factors are interdependent on each other. A huge factor is also the pharmaceutical industry that hasn’t been touched upon here. So, is there no light at the end of this tunnel? There is.

Some reforms in government schemes and medical practices may inch us forward to better healthcare for now. How do we make healthcare more affordable in India?

  • Setting up more number of medical colleges and healthcare training centers. Employing quality staff and increasing the number of seats in medical colleges and specializations is also necessary right now.
  • Introduction of transparency in healthcare sector with digitalization of the entire hospital admission and care for a patient.
  • Introduction of government run public health insurance at affordable costs.
  • Increasing number of primary health centers and government hospitals in rural areas. Private players too can be incentivized to open up health centers and hospitals in remote areas.
  • Strict regulations of private hospitals to minimize erratic billing and overcharging for treatments.
  • Increased use of indigenous medical equipment and generic medicines to reduce imported drug use
  • Encouragement to Day surgery and short surgery centers to ease hospital load and perform quick elective surgeries (Hernia, Piles, Uterus Removal, Gallbladder removal etc) on outpatient basis at affordable costs.