Indore: Around 65% of India’s population, or more than 90 crore people in India, lack social financial health protection schemes owing to coverage gaps and are pushed to procure private insurance for health coverage, said Indian Medical Association (IMA) national president Dr RV Asokan here on Sunday.
“This ‘uncovered’ population is termed as the missing middle. In India, 25% of people are covered by Ayushman Bharat scheme, 10% are affluent enough to afford their own care but for the middle, comprising around 65%, or approximately 90 crore people, govt has nothing to offer. Instead govt is pushing them to purchase private health insurance and imposing 18% GST for acquiring health insurance. It’s exceedingly unfair. The requirement is for a tax-funded universal healthcare system to provide access to healthcare to this substantial section of people,” Dr Asokan told TOI during the IMA-Indore chapter conference.
He emphasised that outpatient care, which constitutes 63% of the entire healthcare expenditure in India, is neither covered under Ayushman Bharat nor private medical insurance, thus providing no avenue for reducing catastrophic healthcare expenditure.
“There is a necessity to alter the direction through policy and the govt to acquire holdings in the hospital industry. In India, the focus has shifted from public sector to for-profit hospitals that have now assumed leadership roles. To further compound the existing challenges of the hospital industry, the government has added the insurance industry whose package style is more suited to for-profit hospitals,” said Dr Asokan.
He said that the insurance industry has also eliminated small and medium hospitals that were vital in maintaining reasonable healthcare costs.
The IMA president said that Indian govt is focused on producing more doctors by establishing new medical colleges but not addressing the crucial need to increase hospital bed capacity through enhanced sector investments.
“There are 706 medical colleges in India, producing over just 1 lakh doctors annually. The doctor-population ratio is 1:811, which surpasses WHO’s 1:1000. However, no one addresses the shortage of hospital beds and insufficient infrastructure for patient care. There is inadequate commitment from govt to invest in health,” said the IMA chief.
Dr Asokan said India has not learnt any lessons from Covid-19 and healthcare remains a non-priority sector. “Investment in health sector has remained stagnant between 1.1% and 1.3% of GDP, which should be at least 2.5%. All neighbouring countries, especially in Southeast Asia like Bangladesh and Sri Lanka, are spending around 5% of GDP on healthcare,” said Dr Asokan.
The IMA chief asserted that teaching MBBS in Hindi is “impractical”. “These (decisions) are politically motivated, it’s like ‘playing to the gallery” Teaching MBBS in Hindi is not practicable at this stage. In translated books, English words are simply being cut and copied…. Modern medicine is based in English and today our doctors are positioned everywhere globally because of the power of the English language. English is a soft power of this country and what purpose does losing that serve? Instead of contemplating about language, one should utilise our strength to become a power,” said Dr Asokan.
