Private healthcare needs reform in public interest
- Millions of Indians underwent traumatic experiences while seeking treatment during the COVID-19 pandemic.
- This strongly underlined the urgent need for two complementary streams of change in our healthcare system: strengthening public health services and regulating private healthcare providers.
- In the Indian context, no initiative for reforming the health sector will be complete without touching upon private healthcare, which accounts for around 70% of healthcare utilisation in the country.
Key highlights
- The 2024 Forbes list of billionaires includes 200 Indians.
- Following manufacturing, the industry that contributes the second largest number of billionaires in India today (36), is healthcare, including pharmaceuticals.
- Private healthcare in India is allowed to make high profits, because it is inadequately regulated and often charges patients exorbitant rates.
- This setting underscores the relevance of policy recommendations contained in the recently published Jan Swasthya Abhiyan’s 18-point People’s Health Manifesto.
Transparency, standardization of rates
- Private healthcare providers are perhaps unique among all the commercial services in India, since the rates of their services are generally not transparently available in the public domain.
- The Clinical Establishments (Central Government) Rules, 2012 specify that all healthcare providers must display their rates and should charge standard rates as determined by the government from time to time.
- However, 12 years after these legal provisions were enacted, surprisingly they are yet to be implemented.
- It is also necessary to implement standard protocols to check irrational healthcare interventions, which are currently promoted on a wide scale due to commercial considerations.
- Rationalising treatment practices and curbing excessive medical procedures will not just bring down excessive bills charged by many private hospitals, but also significantly improve healthcare outcomes for patients.
Implement patients’ rights
- These include the right of every patient to receive basic information about their condition and treatment, and the expected costs of care and itemised bills;
- In the Indian context, the National Human Rights Commission formulated a set of patients’ rights and responsibilities in 2018.
- Further, given the failure of existing mechanisms like Medical Councils to ensure justice for patients with serious complaints related to private hospitals
Control commercialisation of colleges
- There is an urgent need to control commercialised private medical colleges, especially mandating that their fees must not be higher than government medical colleges.
- Further, expansion of medical education must be focused on public colleges rather than commercialised private institutions.
Conclusion
- The National Medical Commission needs independent, multi-stakeholder review and reform, keeping in view criticisms that this body lacks representation of diverse stakeholders, has excessively centralised decision-making, and tends towards further commercialisation of medical education.
- Today, all political parties should commit themselves to implementing these transformations, while as citizens we must strongly demand them. This would be a fitting manner to celebrate World Health Day in India in 2024.