As we gear up for welcoming the new year 2020 amidst the rising cost of living, pollution in the cities and an exploding population, here is a look at the hopes, fears and aspirations with regards to healthcare trends in the New Year.
Health, as we say, is the absence of diseases and a feeling of physical, mental, emotional and social well-being. By healthcare industry, we mean – Healthcare professionals, caregivers, hospitals, health Insurance, Medical tourism, Medical equipment and Pharmaceuticals, drug Inspectors, etc.
The central government has allocated about Rs 62,659.12 crore to the healthcare sector for the fiscal year 2020 out of which about Rs 32,995 crore has been allotted towards the National Health Mission (NHM) itself.
The government has increased funding in setting up the following programmes: Ayushman Bharat Health and Wellness Centres under the National Urban Health Mission, the National AIDS and STD Control Programme, The National Programme for Health Care for the Elderly, National Programme for prevention and control of Cancer, Diabetes, Cardiovascular Disease and Stroke.
These initiatives do show a more comprehensive and reformist vision but if one considers that the health expenditure in India more or less remains at an embarrassing 1.02 per cent of its gross domestic product (GDP) since 2009. This is a figure that is much lower than what is spent by countries considered to be having low incomes relatively like Sri Lanka, Thailand, Indonesia, etc. in the health and welfare of their people.
Challenges lying ahead in 2020
While India can pat its back for eradicating Polio and for the sharp decrease in new HIV cases, it still needs to brace up for the fight against the following communicable and non–communicable diseases to achieve its health goals.
Infectious Diseases in the year 2020
HIV and AIDS
In the last decade, aggressive awareness campaigns along with timely and subsidized treatment have resulted in a commendable 56% decrease in AIDS-related deaths in India and a 27 % decline in new HIV cases. However, India still has the third-highest number of HIV patients in the world which is always a significant challenge for the coming year.
The goal has been set to eradicate Tuberculosis by 2025 goal, though we have been slipping back on these targets, the earlier aim was to eliminate T.B. by 2017. India was found to harbour the highest number of T.B. cases in the year 2014. With the emergence of Multi-Drug Resistant (MDR) T.B. and poor compliance of the drug treatment, the risk of T.B. becoming an epidemic is very high.
We need more research, sharper diagnostic criteria and not just sputum positive and Chest radiographs to start the treatment, especially in atypical presentations. We need a more significant number of dedicated DOTS centres to make the waiting period less for a suspected T.B. patient to ensure faster diagnosis and prompt treatment.
Leprosy that was eradicated a decade back is making a comeback with the detection of 135,485 new leprosy cases in India in 2017. Here again; we need more research to create more potent drugs to fight the drug-resistant strains.
Vector-Borne diseases are like Malaria, Dengue, Zika, Diarrhoea, Chikungunya and Scrub Typhus etc. After Sub-Saharan Africa, India has the world’s most massive reported outbreaks of Malaria. Unsanitary conditions, delayed and faulty diagnosis are the main culprits.
We need rapid diagnostic kits at primary health centres to ensure that the epidemic is controlled sooner than later. These diseases post a grave burden of disability and morbidity on the working population.
Non-communicable chronic diseases like Diabetes, COPD, Hepatitis, Cancer, Cardiovascular diseases, Stroke, Obesity, Depression, Musculoskeletal diseases, etc. continue to claim a large part of our adult and elderly population.
Early detection and affordable treatment is the key to treating non-infectious diseases.
Challenges For Health Infrastructure In Public Sector
Our Constitution holds the state responsible for health care and free medical care for all. Yet the states have been failing at providing all-encompassing healthcare to all the citizens for the below reasons.
Inadequate priority and funding
Health and sanitation remained and remain a poor cousin compared to Defence when it comes to budget allocations. We need to increase funding to build more toilets, provide safe drinking water, more health care centres in rural areas to nip many diseases in the bud.
Inadequate well-trained staff
With very few medical colleges and a decline in the allure of the medical profession as a career, we see scarcity in the number of medical professionals to cater to the need of our population.
The medical practitioner serving in the public sector needs more incentives and motivation.
Lack of accountability and quality checks:
These are the other factors that are reasons for the declining faith in the public sector of healthcare. The rising cases of mob rampage and violence against doctors is an indicator of growing dissatisfaction with the state of affairs in government hospitals.
How Can We Achieve Better Health For All
Integrated Health Schemes or subsided treatment policies at Private Hospitals
The state and central government can only provide the necessary infrastructure and funding, which is inadequate considering the vast Indian population. The government can set rules and regulations to be followed but let us not forget the other key player in the health care sector – the private sector, which is headed by doctor entrepreneurs or small clinics.
Subsidized Treatment at Private Hospitals
The general public has better satisfaction in the private setups due to better technologies and the better patient to doctor ratio and other reasons like lesser waiting time. Still, they do not trust them entirely as many such organizations are run as businesses with the sole aim of getting profits, and that is reflected in unnecessary tests, expensive medicines making the patient incur significant medical bills.
There is a need to devise a strategy to engage allocate, monitor and regulate private players in healthcare to curb malpractices and reduce cost of treatment.
Plural Systems of Medicine
Many people trust alternative systems of medicine in chronic diseases, and the integrated approach is more successful even in treating cancer cases. The government can rope in and integrate these alternative practitioners of Homoeopathy, Ayurveda or even yoga in the public domain to increase the number of practitioners who can cater to the basic needs of treatment at primary level.
Role of Insurance
The insurable population in India has been assessed at 25 crores. Even at a minimal premium of Rs 1,000 per person, we can raise Rs 25,000 crores per year, a figure that can meet the demands of this fast-growing market and cover the related technological developments in medicine.
Insurance should also be required to extend beyond
Insurance cover should extend to conditions like ambulatory maternal care and Asthma or COPD, which are life-threatening though the patient may not need hospitalization.
With the introduction of the National Medical Commission Bill 2019, it seems the stage is set for some path-breaking changes in medical education and Hospice care. Let us hope that we see the implementation of a Plural system of medicine and Medical Insurance in the year 2020 and better funding to government schemes.