Just a couple of weeks back, some tens of thousands of American citizens got together to protest US President Barack Obama’s healthcare plans. Obama has been trying his best to expand health coverage for American citizens, at the same time also trying to arrest the ever increasing healthcare costs in the US. As per his plan, healthcare is going to adequately cover as many as 97% of the American population. Currently, it is estimated that around 46 million Americans do not have health cover and around 25 million of them are not adequately covered. Now, on the face of it, the plan looks fine; but what has agitated an average American is the very fact that this plan (of adequately covering 97% Americans under health insurance) calls for a budget of $600 billion, which would be mobilized through higher taxes. This element of higher taxes has antagonized the Americans, coupled with the fact that they do not want the government to interfere into health affairs. Such is the fury among Americans that Obama’s popularity has taken a severe beating on account of his health plan initiatives! What is interesting is the fact that sitting in India, an average Indian might be wondering why Americans are going wild over their President? Agreed, as per Obama’s new plan, an average American has to pay more taxes; but then, even that should not annoy them. Simply because out here in India, even after paying taxes, there is absolutely nothing in the name of health cover that a citizen gets! That too considering that an average Indian is at least 20 times poorer than the average American. And mind you, here we are talking about averages, wherein the reality is that almost 400 million Indians do not even make two dollars a day! Although healthcare costs are relatively lesser in India as compared to the US, but then in income parity terms, it is much higher. As per reports, on an average, healthcare costs in India are around one fifth to one tenth that of America, which makes Indian healthcare even more expensive (almost double of that of an American in America) for an average Indian. Also, it is a known fact that there is almost nothing in the name of health insurance. Currently, an abysmal 10% of the population is covered under health insurance. On top of that, there are no records whether this 10% population is adequately insured or not. To put it on record, with respect to health insurance, India is the worst performer in the category of large nations. No wonder why an Indian wonders when an American protests! This, coupled with the fact that public health infrastructure is too poor, forces most Indians to resort to private treatment even for curable ailments. It is estimated that on account of poor public health infrastructure, the out of pocket expenses as a percentage of total health expenditure is a staggering 80% for Indians. A few years back, the World Bank had reported that health expenses are the single reason of driving a majority of Indians towards poverty! In fact, it is a known fact that we need to increase our budgetary allocations on health; but then, what is even more perilous is the fact that whatever budgets are being allocated are going in to pay salaries of existing doctors and administrative staff. There is hardly anything left for creating infrastructure or provisioning insurance. And mind you, this is all tax money; and so there is no reason why an average Indian should be amused when an American protests. And the final icing comes when the large private players of the healthcare sector do not abide by the mandated requirement of provisioning world class health facilities to poor, absolutely free of cost. It has been recently reported that of the 38 private hospitals in Delhi, 22 have not been adhering to the norm of providing free healthcare (OPD) facilities to 25% people who are poor. This against the backdrop that in 2007, the Delhi High Court had directed all the 38 private hospitals to provide free treatment, against which they had been granted prime land by the Delhi Development Authority or the Land and Development Office. And these are big names including Max, Fortis, Gangaram et al. In fact, as per some reports, hospitals like Moolchand and Rajiv Gandhi Cancer hospital have been outrightly refusing to treat the poor. And what is even more interesting is the fact that Apollo has been charged with a fine of a meagre Rs. 2 lakhs for not adhering to this norm! In fact, as per the ruling, 10% of the beds were to be allocated to the poor. And it is no secret that there is a blatant abuse of the same by these hospitals. If this is the state of affairs in Delhi, one wonders how it would be in other parts of the country. All this leaves an average Indian, who is poor, wondering as to why an American protests when their President is trying his best to provision healthcare for all in lieu of a higher tax. For that Indian knows the fact that the concept called universal healthcare is still a farfetched dream for him!!
- 01 October 2009 |
- Dr. Arindam On America