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The coronavirus pandemic may have come as a wake-up call for an otherwise undisciplined healthcare system in India. In the normal course, the investments that the government is currently making in healthcare might have taken years. Mint takes a look at the situation.

What’s the state of our public healthcare?

India’s healthcare spending is 3.6% of GDP, the lowest among developing countries. Often, funds allocated to states for healthcare are unutilized or underutilized. Private healthcare, preferred for its quality, is costly and, thus, out of the reach of the poor. Government hospitals have 713,986 beds in total, or 0.6 beds per 1,000 patients. There is a shortage of primary healthcare centres and community healthcare centres by 22% and 30%, respectively. The rural healthcare system has long been suffering from a shortage of medicines and instruments, as well as healthcare workers, and often lacks even basic amenities.

Are out-of-pocket health expenses high?

Out-of-pocket (OOP) expenses are borne directly by the individual and paid to the health service provider without any aid from an insurance company or the state. India (62.4%) ranks high on this tangent against the world average (18.55%), driving millions to poverty every year. While there is no one-stop solution, state governments could consider OOP as an indicator of their healthcare system performance. Provision of quality healthcare at an affordable cost and comprehensive health insurance coverage for vulnerable groups are not new ideas, but once achieved could make a big difference.

Graphic: Paras Jain/Mint
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Graphic: Paras Jain/Mint


What is the govt’s strategy in the current situation?

The government has imposed a strict countrywide lockdown to limit the spread of the virus and is trying to upgrade the healthcare infrastructure as quickly as possible. Priorities include new beds, hiring of medical practitioners on contract, higher capacity of intensive care units and trying to meet the demand of ventilators and personal protective equipment.

Do the hospitals have enough ventilators?

India has around 45,000 ventilators. Global experiences show that 5-10% of covid-19 patients need ventilator support. As all ventilators cannot be pulled out from intensive care units, the number that is available would not be enough. A steady import base for ventilators is unlikely as global supply chains are strained, but local manufacturers are ramping up their production capacity. Even after things go back to normal, India would need these ventilators to treat the many citizens who suffer from respiratory diseases.

Are there enough doctors for patients?

India has 0.8 doctors for every 1,000 patients, compared to 4.1 in Italy; still, the latter had to choose whom to provide treatment to when the situation worsened. The number of doctors cannot go up in the short run, but paramedical workers could be trained for blood pressure monitoring or routine checks to take the load off doctors. Also, patients with other ailments might need hospitalization. In such cases, the use of telemedicine should be encouraged.

Jhoomar Mehta is a Delhi-based development finance consultant.

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