Bharat has just 2.3 critical care beds per 1,00,000 people whereas Italy which has 12.5 ICU beds per 1,00,00 people is now almost on the verge of total collapse due to the rapid spread of corona virus. In Italy, the corona cases that were negligible during 15th February to 29th February, 2020, rose rapidly from 1st March, 2020 and has now clocked 53,578 active corona infected cases and 4,825 deaths which is the highest in any country as on date.
The immediate impact of the corona virus on Bharat’s economy will be in tourism, aviation, transportation, FMCG and hospitality industries. The sections of the people that are likely to get hit the most are- poor farmers, daily wage earners in rural and urban Bharat and aged persons.
Also our country’s health infrastructure is very weak and will totally collapse if the corona virus breaks rapidly as it happened in Italy. Let us hope and sincerely wish it does not happen but we need to prepare for the worst scenario right now on war footing basis since we are running short of time and the next three to four weeks will be very crucial and going by the current trends we have been witnessing in countries like- Italy, China, Iran, Spain, USA and France we cannot remain complacent.
Challenge of Affordability of Health Care in Bharat
For the 300 million Bharatiya citizens who live below the poverty line, ordinary healthcare costs are prohibitively expensive. Close to 40% of Bharatiyas live on less than US $1 per day and most of them pay out of pocket for their healthcare. Out-of-pocket spending in Bharat is over four times higher than public spending on healthcare. According to Centre for Disease Dynamics, Economics & Policy (CDDEP) in the US, in Bharat, out of pocket expenditure constitutes 65 percent of the health expenditure, pushing around 57 million people into poverty every year.
Health Care Infrastructure in Bharat
It is estimated that Bharat has shortage of 600,000 doctors and 2 million nurses. In Bharat, there is 1 government doctor for every 10,189 people as against the WHO’s recommendation of doctor’s to population ratio of 1: 1,000. Similarly, Bharat has 0.9 hospital beds per 1,000 people as against the WHO recommendation of 5 Beds per 1,000 people. There are 23,582 government hospitals having 710,761 beds in the country. 19,810 hospitals are in rural area with 279,588 beds and 3,772 hospitals are in urban area with 431,173 beds.
70% of population of Bharat lives in rural area and to cater their need there are 156,231 Sub Centres, 25,650 Primary Health Centres and 5,624 Community Health Centres as on 31st March 2017. Urban areas have fewer (government) hospitals, around 3,700, but the majority of the beds totaling above 4.3 lakh are in urban areas as against the overall 7 lakh beds across the country.
The shortage of hospitals in rural Bharat is acute compared to the urban places. While there are 6,49,481 villages in Bharat, according to 2011 census, as on date there are only 28,863 PHCs across the country and just one fourth of the doctors all over the country are serving in villages.
Bharat’s position in Health Care Globally
Bharat ranks 102 among 117 countries in terms of quality and accessibility of healthcare, behind its neighbours like China, Bangladesh, Sri Lanka and Bhutan, according to a Lancet study. However, in 1990, Bharat’s ranking was 153 which improved to 145 in 2016. In 2016, Bharat’s healthcare access and quality scored at 41.2 (up from 24.7 in 1990).
“Although India’s improvements on the HAQ (healthcare access and quality) index been positive from 2000 to 2016, the gap between the country’s highest and lowest scores widened (23·4-point difference in 1990, and 30·8-point difference in 2016),” the study stated. According to the study, Bharat performed poorly in tackling cases of tuberculosis, rheumatic heart diseases, Ischaemic heart diseases, stroke, testicular cancer, colon cancer and chronic kidney disease among others.
Top 4 countries that spend on Health (OECD data)
|Country||Health expenditure as % of GDP|
In Bharat, the total health expenditure is 4% of GDP, which is less than half of the OECD average of 9.3%. This also clearly indicates that the private or out of pocket expenditure in Bharat is around 2.6% of GDP as against the government’s expenditure 1.4% of GDP.
While the above data reveals that Bharat has a long way to go as far as investment in health care and health infrastructure are concerned the critical need of the hour is to tide over the impending corona virus crisis.
The author suggests the following measures to be implemented immediately in full force across the nation:
- All offices and business organizations to start work from home facility to their employees.
- All educational institutions to remain closed and colleges, Universities and B Schools to function online.
- Judiciary to work on online mode to dispose the cases.
- RBI to allow the banks to function with minimum staff by permitting the staff to work on rotation basis.
- Prohibition of public gatherings and functions till the corona pandemic fully comes under control.
Apart from the above, following measures can be adopted to encourage more participation by the corporates:
- ICMR and CCMB to work in collaboration to evolve a common strategy for testing of corona virus patients and to fight the spread of this virus.
- Amend the Companies Act to enhance the minimum spending of corporates under CSR from 2% of their three-year annual average net profit to 4%.
- The incremental 2% mentioned above to be exclusively spent for Health Care sector also covering health infrastructure (both core and soft infrastructure like IT).
- Extend total tax exemption for the incremental 2% CSR expenditure mentioned in point no.3.
- Also extend tax exemption to those corporates who do not fall under the criteria of mandatory CSR obligations as per the Companies Act but volunteer to spend or donate for the pool of corpus meant to tackle this corona virus.
It is reported that the Bharatiya government is thinking of rescuing the aviation sector by announcing a package of Rs.120 billion. Other sectors like- telecom and tourism are likely to join this race in view of the adverse impact of the corona virus. The governments both centre and the states have an uphill task to overcome the current challenges.
Few states like- Kerala and UP have taken the lead in arranging the food supply and giving grants to the poor at their doorstep. The government has to relax the cap on fiscal deficit (for both centre and the states) and channelize the funds towards health and food subsidy on high priority.
All the citizens have to take necessary preventive measures, help others and support the government so that the country will come out of this crisis. Hope Bharat will convert this crisis into an opportunity to strengthen its healthcare systems by adopting a Public private Partnership Model with the joint collaboration of government, private sector and health insurance companies.
(Featured image source)
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