HEALTH MATTERS. A new beginning for a healthier India

The new year started on a positive note for the healthcare sector with the release of the Draft National Health Policy in the public domain.

What was encouraging is that the announcement came in the wake of a recent report that spoke about the government ordering a cut of nearly 20 per cent in its 2014-15 healthcare budget. This was an ominous signal which, I believed, would be a major setback in our mission to build a healthier India.

The Draft Health Policy provides a clear insight into the nation’s healthcare vision. The health and family welfare ministry’s desire to make the right to health a fundamental one speaks of a clear will to improve the healthcare system.

India has reached a stage where universal healthcare coverage is an imperative. While the draft is step in the right direction, it now has to be backed up by action.

Policymakers need to recognise that increased coverage will come at a cost that is substantially higher than our present and proposed spend of GDP on health.

This point is well demonstrated by Brazil, which has been spending almost 9 per cent of GDP on healthcare for several years.

In contrast, the Indian scenario has been one of insufficient resources and a vivid absence of the determinants of good health such as clean drinking water, sanitation, nutrition, preventive healthcare and basic education. In addition, India’s health indicators lag behind its millennium development goals and the public healthcare infrastructure with regard to number of beds and medical personnel falls short of WHO guidelines.

This is further compounded by the rampant dichotomies in our healthcare ecosystem.

Our clinical delivery system unfortunately is best described as islands of excellence in an ocean of inadequacy. While we have set global benchmarks in some facets of healthcare, the fact remains that millions of our citizens are unable to access even primary healthcare facilities.

The most worrying aspect of this grim picture is now apparent in our rising disease burden. Non-communicable diseases and infectious diseases continue to take a huge toll across urban and rural India. The treatment for the same is paid for out of pocket by most of the population, and it has emerged as the number one reason for indebtedness in the country.

The foremost aspect that India needs to bear in mind is that ensuring universal access to healthcare can never be a destination but will always be journey and moreover, it should be underscored by continuous focus on high quality. This goal would then be closer to the WHO’s constitution in which it attests to a right to the ‘highest attainable standard’ of health.

While there are many perspectives about the definition and role of a Fundamental Right, most often it is assumed to be almost that of guarantee to support the larger social good. It also undeniably shifts the focus from the individual to an expansive affirmative duty of the government.

Personally, I believe that the ‘Right to Health’ is divergent from ‘Right to Healthcare’, and for a nation’s administrators to guarantee this aspect, it needs to be able to control the lifestyle choices and behaviour of its citizens.

For us to imbibe the ‘Right to Health’ in its fullest spirit, it will require the concerned stakeholders to create an ecosystem where both healthcare and the tenets of healthy living are a responsibility of the government, the healthcare sector, society at large, and every single citizen of the land.

Crucial facets such as access to high quality healthcare, preventive health checks, and comprehensive and inclusive health insurance will all be vital in the fruition of this vision.

The benefits of this will be game-changing — it will nurture an environment which will help Indians unleash their potential and cumulatively it will have a huge multiplier effect on the economy.

The US, which has very detailed and mature empirical studies, has comprehensively analysed the economic impact of healthcare reform. The report suggests that if we are successful in bringing down the cost of healthcare by even 1.5 percentage points, the GDP would be up by 8 per cent over a period of time.

In 2014, we conquered Mars; it was the inherent innovative India at work. Now in 2015, India needs an innovative prescription to fix its healthcare challenges.

Alongside fixing the constraints, we need to leverage our nation’s health legacy which dates back centuries and also embrace wellness and holistic living as potent stepping stones to build a healthier and happier country.

The writer is the chairman and founder of Apollo Hospitals group