Bharat’s Healthcare Infrastructure – Survival is the Mother of Innovation

The advent of Coronavirus has exposed the weaknesses in healthcare infrastructure in Bharat and how vulnerable we are if a pandemic spreads rapidly across the country. 

There are only 48,000-odd ventilators in the various hospitals across Bharat, with around 40,000 in the pipeline. Experts say Bharat will need 80 to 100 times the number of ventilators if the current Coronavirus spreads.

Bharat needed around 38 million masks and 6.2 million pieces of PPE (Personal Protective Equipments) to take care of Covid-19 patients according to Reuters report. Last week, the government issued a statement detailing its plans to procure 6.2 million PPEs desperately needed across the country.

In a statement the health ministry said, by April 10, Bharat would import around 1 crore PPE kits which will also include N-95 masks. Ministry of Health in collaboration with the Ministry of Textiles, Department of Pharmaceuticals (DoP) and the states, is monitoring the requirement of PPEs, masks and ventilators. 

Sensing the urgency of the situation and the scope to enter Bharat’s healthcare market, several corporates and small and medium enterprises are ready with their business plans. Automobile companies are re-engineering their manufacturing capabilities to bring out ventilators. Mahindra & Mahindra, in partnership with two public sector units, is working on a basic ventilator model that would cost less than Rs. 10,000 as against Rs 5-10 lakh as it does now.

Bharat’s largest auto maker, Maruti Suzuki India Ltd (MSIL), has entered into a partnership with AgVa Healthcare to scale up production of ventilators. The company aims to manufacture 10,000 units per month. A Gujarat based company, Jyoti CNC Automation Ltd. has successfully manufactured ventilators in 10 days’ time. Testing and certification has also been completed and the Gujarat government has announced that these ventilators will be put to use in the hospitals.

IIT- Roorkee has also developed a low cost portable ventilator which can be useful in the fight against COVID-19.

Indian Railways are planning to convert 20,000 coaches into isolation wards. Asset Homes, a building firm from Kerala has even submitted a proposal to the Government of India and disaster management officials to convert the railway coaches into mobile hospitals and operate across the country covering 7,300 plus railway stations spread over the length and breadth of the country.

As Bharat continues to tackle the ongoing crisis, drone startups in Bharat are working alongside authorities providing services such as disinfecting contaminated areas, managing crowds and delivering medical supplies. Expectedly, leading Bharatiya corporates have come forward to donate generously in support of the government’s efforts to tackle this coronavirus. 

There are two important lessons we should learn from the above. One– there is good scope for social entrepreneurship in Bharat’s healthcare sector. Two– In a crisis people and organisations with positive mind convert the problems into opportunities. 

Bharat’s Healthcare Scenario

In Bharat, a meagre 9.6% of the overall healthcare expenditure goes towards preventive healthcare, whereas 90.4% goes into treating diseases and their complications (i.e., curative healthcare) amounting to more than Rs 3.6 lakh crore per year. Also, close to 50% of such expenses go towards inpatient beds for lifestyle diseases, especially in urban and semi-urban pockets (according to the IBEF Healthcare, 2014).

High out-of-pocket expenses push 7% of the population into poverty each year. For primary healthcare, Bharatiya government spends only about 30% of the country’s total healthcare budget. Out of 135 crore people, only 27% have health insurance in Bharat, according to the data from National Health Profile (NHP) released in April, 2017. Overall 80% of all persons covered with insurance fall under government sponsored schemes.

Healthcare-associated/ acquired infections (HAI), known as Nosocomial infections, continue to be an important patient safety problem in developing countries including Bharat and the financial and social costs are very high.

An estimated 469 million people in Bharat do not have regular access to essential medicines, according to the WHO. Bharatiyas are the sixth biggest out-of-pocket (OOP) health spenders in the low-middle income group of 50 nations, as per a May 2017 IndiaSpend report. “Around 70 per cent of the overall household expenditure on health is on medicines; which is an important factor contributing to poverty.”

The above data indicates the government is unable to spend more on preventive healthcare which is very important. A major portion of the income of the common man in Bharat goes towards health expenditure and only small portion of the country’s population have health insurance facility. 

Healthcare a growing market in Bharat

In spite of the issues mentioned above, the hospital industry in Bharat, accounting for 80% of the total healthcare market, is witnessing a huge investor demand from both global as well as domestic investors. The hospital industry in Bharat is expected to grow CAGR 16-17 percent to reach INR. 8.6 trillion ($.132.84 billion) by FY-2022 from INR 4 trillion ($. 61.79 billion) in FY-2017.

The hospital and diagnostic centers attracted Foreign Direct Investment (FDI) worth US$ 6.34 billion between April 2000 and June 2019, according to data released by the Department of Industrial Policy and Promotion (DIPP).

Therefore, if appropriate policy measures are taken by the government, our healthcare sector can see a paradigm shift. In order to address the above mentioned gaps in Bharat’s health care and particularly in rural healthcare, the following policy measures are to be seriously considered by the government:

1. Setting up one medical college in every district in the country. Providing subsidized/ free medical education to the students from rural areas with a caveat to serve in the villages after becoming doctors. 

2. Encourage PPP Models in rural healthcare by collaboration between the government, private hospitals and health insurance companies. 

3. Ensure every citizen of the country is covered under health insurance through appropriate legislative measures. 

4. Make master health checkup mandatory for annual renewal of health insurance cover in order to focus more on preventive health care and thereby reduce the burden of disease on curative healthcare. 

5. Creation and maintenance of master health records of all the citizens on real time basis after taking necessary measures that the right to privacy of the people is duly maintained.  

6. Government expenditure on healthcare to primarily focus on the following activities-  providing the health infrastructure and supporting the initiatives of the private sector in providing health infrastructure, bearing the health insurance premium burden of the poor and deserving people. 

7. All government hospitals to charge the patients for the health services who in turn will shift this burden to health insurance companies as they are covered under health insurance. 

8. Bringing health sector under the concurrent list of the constitution (currently it is under the state list) so that both the centre and the states could enhance their budgetary allocation under the health sector by adopting a uniform approach.

9. Abolish all the health schemes (both centre and states) and instead the governments to spend those funds only for the health insurance premium of the people by either fully funding or part funding of the annual health premium depending on a standard guidelines.  

10. To bring under price control various health interventions, including diagnostics and medical treatment along with medicines, in due course.

If necessity is the mother of invention, survival is the mother of innovation. Can Bharat convert this current Coronavirus crisis into an opportunity to revamp its healthcare? 

(Featured image source)

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About the Author

Dr. B.N.V. Parthasarathi
Ex- Senior Banker, Financial and Management Consultant and Visiting faculty at premier B Schools and Universities. Areas of Specialization & Teaching interests - Banking, Finance, Entrepreneurship, Economics, Global Business & Behavioural Sciences. Qualification- M.Com., M.B.A., A.I.I.B.F., PhD. Experience- 25 years of banking and 14 years of teaching, research and consulting. 100 plus national and international publications on various topics like- banking, global trade, economy, public finance, public policy and spirituality. One book in English “In Search of Eternal Truth”, two books in Telugu and 20 short stories and 27 articles published in Telugu. Email id: [email protected]