Union Budget 2019: Over the last two decades, the use of health insurance has increased many folds in the country. But it amazes me to see that in India the premium for health insurance per lakh of money is far less than car insurance premium per lakh.
By Dr Kapil Kochhar
India is a unique country where we have two parallel systems of healthcare delivery, private and state-owned and the number of users is huge in both. So we expect the government to look after expectations of both the systems. The facilities in top-notch private and government setups are same but the sheer load in government hospitals affects their efficiency badly. Hence majority of quality healthcare is being provided by the private sector. It’s high time that the government considers this sector as an essential service provider and works for its betterment. Just to highlight a few problems any medical equipment which is not manufactured in India especially the high-end ones should have nil or minimal import duties. This will enable more hospitals to acquire cutting edge technology and thus quality care can be delivered to more people that too at an affordable cost.
Over the last two decades, the use of health insurance has increased many folds in the country. But it amazes me to see that in India the premium for health insurance per lakh of money is far less than car insurance premium per lakh. People hate to spend money to keep their body safe but willingly spend many times more to keep their cars safe. However, in recent years insurance has become a big cartel in India just like the USA. Even Delhi high court recently pointed this. Steps should be taken to root out corruption from health insurance and hospital empanelment should be made simpler. Any hospital which gets a government registration should automatically get insurance panels too. The rationing of prices for procedures which is being done by the insurance companies, especially the government insurance companies, should be scrapped. As nursing homes and hospitals cut corners to keep the prices down which are detrimental to the quality of healthcare.
Recently we have witnessed that health ministries are capping the treatment costs for certain procedures in private set ups. This also has detrimental effects. If you really want the prices to come down just increase the competition. This can be done in two ways. First increase the number of hospitals. Second improve the government hospital services so much that more people start using them. While increasing the number of hospitals government should promote individual doctors rather than big corporates to open up hospitals. These will be more ethical and once there are many hospitals the treatment costs will become rationalised automatically due to stiff competition. Like we have seen in telecom or even hotel industries. The land price is so exorbitant that only big corporates can buy it and thus they run it like an industry. So land should be allocated at cheaper prices especially in areas where there are no hospitals. This will be a win-win situation for both the parties. The place will get a hospital and the investment will be less.
Rather than opening up and running new hospitals government should give a serious thought on public-private partnership model. They should make a hospital , equip it but running it should be left to private players. Rather than spending directly they should invite bids from individual doctors and corporate players to run the hospital for them. The government should be paying the administrator who should run the show. And there should be watch dogs from government side in the board to oversee any corruption. Last but not the least. In last ten years or so India has become a hub for medical tourism from neighbouring countries and now even many African countries. This brings in cash revenue not only for the hospitals but also to hotels , food industry and even retail sales. As patients always come along with family members. Thus after treatment they even go for shopping and sight-seeing. Government should allow exchange programs with Drs from those countries. That way we get more patients from these countries and their doctors will also get better training thereby strengthening the bonds between the countries.
(The author is Additional Director, Department of Bariatric, Minimal Access and General Surgery, Fortis Hospital, Noida. Views expressed are personal.)