India's failing healthcare system, with latest tragedies from Gorakhpur and Farrukhabad in Uttar Pradesh, makes one question the system and the options involved, especially since most of the deaths in these cases seem to be from preventable causes.

The malfunctioning healthcare system that we have has been slowly coming to light. A National Sample Survey Office (NSSO) from 2014 found that more Indians chose private healthcare options over government ones, and that over the past few years, the number of patients who choose public facilities has only improved by a fraction, despite greater funding to the National Rural Health Mission (NRHM). 

In most cases, people only choose government healthcare options out of compulsion, if private options are not available, and a survey by Centre for the Study of Developing Societies (CSDS) found that almost 47% of people who visit government centres do so for the same reason. Even among those who do go to public centres, do so only because of the affordability it accords them, and not because of preference.

But, although private-run medical options may seem better, but no evidence points to such a conclusion. A World Bank Paper by Jishnu Das, which prepared an audit of private and public healthcare systems in Madhya Pradesh found that in private-sector doctors were much less qualified that state-employed ones, and more willing to give adequate time to patients. What state-run options seem to lack, to put it blandly, is a decent bedside manner and better holistic systems in place (accounting only for outpatient consultations). For cases of hospitalizations, however, the difference between the number of users is much less, one cause of which might be the sky-high costs in private healthcare.

Some strategists have suggested a public-private merger to tackle the healthcare crisis, but, overall, the case for private medical care is thin. There is less accountability, and it is more expensive, often involving several redundant procedures and tests, often carrying out unnecessary tests and surgeries. A 2012 paper by Sanjay Basu of the University of California, San Francisco, found that there was no proof of the claim that private medical services were any better than government ones.

Overall, too, expenditures on healthcare have been rising drastically, as a 2016 analysis by Brookings India of the NSSO data found. While insurance is supposed to be the answer to higher costs, high premiums offered mean that the poor get left out. State-run insurance programs (such as the RashtriyaSwasthyaBima Yojana) too fail to cover the required number of households, or offer adequate financial protection, as reported by a research paper by economist Soumitra Ghosh and NabanitaDatta Gupta.

What is needed is that our authorities undertaketo correct this, thinking holistically, and make healthcare - a topic which is neglected in our nation- a priority.

Source: http://www.livemint.com/Politics/gPaI6IG0GA6BWLzpqvzj1L/Why-the-Indian-patient-is-caught-between-the-devil-and-the-d.html?utm_source=newsletter&utm_medium=email&utm_campaign=newsletter