No political demand for good health care Few months back I had an opportunity to listen to Dr Montek Singh Ahluwalia the erstwhile Deputy Chairman of planning commission (now dismantled) at an event. Planning commission used to be most powerful body setting up the various developmental agendas for the country. What he said struck me hard. He said that every day he meets ministers, members of parliament, chief minister and most often they do not ask money for health care. Other sectors such as Industry, agriculture, trade, infrastructure take up the priority on the demand list. If at all any one takes some initiative on the behalf of health care it is mostly demand for tertiary care hospitals such as cancer hospitals or more popular super specialty hospitals or a medical college for their political constituency. As a fall out of this situation the policy making for health care has minimal political accountability as well as least alignment to the needs of the people. As a matter of fact, India is going through a massive re structuring in health care in the present times. Universal Health Coverage is being brought to realty. But there is no public debate on this issues. Except for the scattered trivial media coverage, there is hardly anything above table. This leaves space for background channelling, negotiations, politicking by the middlemen of the lobbying groups. International funding agencies, pharmaceutical companies, tertiary care industry and their representatives have a predominant say in these negotiations. To my understanding, India has the capacity and resources to build up a comprehensive, person cantered and excellent quality health care for the citizen of India through a strong primary care system. However this opportunity is likely to be lost . There seems to be an inclination towards (a) keeping the primary care weak (b) investing public money in building and supporting tertiary care centres in both public and private sector (c) developing and maintaining a drive for high level tertiary care consumption (d) delay or decline regulation of private health care industry (e) delay or decline insurance coverage for primary care , prevention and health promotion (f) Allowing the insurance cover for hospital care only (g) keeping the public health services into several fragmented disease focused vertical programs (h) Continue the wilful wasteful spending of funds allocated to public health spending (i) politically refrain from bringing medical education under rightful regulation and accountability (j) continue regulatory design of human resource development in health care to maintain cheap availability of workforce for tertiary care centres (k) Develop legal framework for consumption pharmaceutical products by non qualified practitioners (l) Keep health projects driven by pressure to spend - budgetary spending as target rather than specific health indices as outcomes. Unless the health care becomes a political demand and electoral issue, the situation is not likely to change. Health care is projected as a booming industry and likely to grow many folds over coming few years. Should the public health policies be synchronized with the growth of health care industry? There is a general mood for economic development in India. But are economic development of a country and growth of health care industry are meant to be in the same basket? As a country shouldn’t India be saving on unnecessary un regulated health care spending? With huge population and morbidity should India target on cut down on level of sickness levels and the spending incurred upon it. Population is our dividend but how are we going to benefit from it if the same population is crippled with disease, illness and sickness. India must strive to develop vision to reap economic benefits of a healthy citizen rather than focusing all public health policies on growth of health care industry. The first priority of public health policies should be alignment with public interest. It is healthy to keep public health policies non contaminated from the interests of health care industry. - Dr Raman Kumar President AFPI (Disclaimer: I am neither a fan nor a political support of Mr Ahluwalia)
Posted on: Mon, 13 Oct 2014 07:49:33 +0000
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