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Healthcare Disparities: A Study of the Indian Healthcare System

Written by Elise Yang

Healthcare is an universal human right that should be undeniably guaranteed to all no matter the circumstance. Every individual is entitled to quality care and the proper alleviation of their pains. In the wake of the twenty-first century, many countries around the world are moving towards fulfilling equitable health for all. While India certainly follows the footsteps of these countries and has taken action in expanding medical accessibility, there is still much needed in the Indian healthcare sector.

It was not that long ago when I had a conversation like this with my Indian-American friends. When I lived in China before moving to the United States, everyone typically went to large — usually extremely crowded — government-funded hospitals for clinical appointments, blood tests, body screenings, surgeries, and everything else you may need. This was because there was enough funding to support a variety of medical procedures in a public facility. On the contrary, the social attitude towards private practices and facilities was generally negative and many perceived them to be unprofessional and untrustworthy. There is an abundance of trust from the public in the Chinese public care system that is not reflected in India. Based on the anecdotes of my friends, the only things I could associate with the Indian public sector are two words: underfunded and understaffed.

Though the private sector is far better equipped, the infamous Indian out-of-pocket-expenditure (OOPE) is simply too costly for a large population of the nation, and marginalized groups are placed at a significant disadvantage. A variety of factors, including socioeconomic inequities, marginalization of ethnic groups, and disproportionate backgrounds all contribute to India’s prevalent healthcare crisis. According to Oxfam India, data captured from the COVID-19 pandemic only unraveled the weaknesses of the healthcare sector even further. The 2017 National Health Profile (NHP) data revealed that there was only “one government allopathic doctor” for every 10,189 people and one state-run hospital for every 90,343 people. The constant underfunding of the public healthcare sector in the last decade has only worsened the medical infrastructure. Between 2010 and 2020, the number of hospital beds reduced from nine to five, with 5 beds and 8.6 doctors per 10,000 population, and India ranks 155 out of 167 countries on bed availability (Oxfam India). Affordability still remains a tremendous issue for many despite the governmental health insurance scheme passed to achieve universal health coverage and less than one third of the households in the country are covered by the insurance scheme by 2015-2016 (Oxfam India).

This begs the question: What can we do to mitigate the health inequalities and build a strong affordable primary healthcare system?

1. Revamping Fiscal Management From the Government

It has long been proven that higher public health allocations demonstrate a positive health outcome not only in times of a pandemic, but also in every day life. A review of the Lancelot Journal reports that less than 3-5% of GDP (Gross Domestic Product) is usually spent on health in developing nations, a reflection of the national government’s attitude towards medical care. India ranks 154th in health-related spending as per the records in Oxfam’s Commitment to Reducing Inequality Report 2020, rendering it the fifth from the bottom. In some states of India, immunization covers as low as 25% due to poor supervision and inadequate financial designation (Lancelot Para. 3). Moreover, despite the clear real-life example that state governments like Odisha and Goa with a higher health expenditure experienced higher recovery rate from COVID-19, the Indian government repeated its mistake of only allocating 2.5% of GDP a year following the pandemic (Oxfam India). If there is anything to be taken away from the aforementioned evidence, it’s that improvement in fiscal management alone can provide much of the valuable inputs the public health sector has been needing for the longest time, without compromising other national priorities.

2. International Support Encouraging Medical Development in India

The Economic Times reveals the shortage of specialist doctors and health workers in India’s countryside, where “more than two-thirds of its 1.43 billion people live.” The World Health Organization (WHO) also states that as India’s population surged, the doctor-to-patient ratio dropped to about 0.7 in 2020. While the current administration is intensifying efforts to expand the healthcare industry while recruiting more personnel, a collective effort from international organizations such as the WHO or even private entities would significantly relieve the workers of the public health sector. An unnamed doctor interviewed on the Economic Times stresses about the demanding workload that comes with trying to provide patient care and teaching undergraduates at the same time. A call could be made to the international community for foreign physicians or medical professionals to volunteer and assist them in their efforts. An international medical committee could be formed to discuss the best methods of managing the patients flow without compromising quality care, and foreign doctors may be stationed to teach at medical colleges or host affiliated remote lectures. This would significantly increase healthcare efficiency, as well as providing respite for the overworked Indian health workers who are trying to balance teaching in their packed schedules.

3. Health Education for the Public

With the existing healthcare structure in India based on the ability of the patient to pay, many people are waiting until the last minute before receiving medical attention (The Times of India). This late interference often leads to more expensive procedures that need to be taken and results in a higher hospital cost. Additionally, the stigma, fear, or denial surrounding taboo diseases like HIV/AIDS are preventing many from optimizing their care by receiving early treatment. Therefore, the general population requires education in the importance of diagnosing chronic diseases followed by the normalization of regular check-ups. More conversations about “socially unacceptable” illnesses need to be prioritized to bolster scientific transparency. With the digital age flourishing today, the power of social media platforms and online forums should be maximized by all medically passionate individuals around the world to advocate for self-care and shed away the relunctant behaviour when it comes to visiting a health facility. The government may also advocate for the establishment of non-clinical interventions such as Telehealth, channeling screening resources in the most disadvantaged areas, and encouraging more engagement by prioritizing one’s physical health.

While the lack of accessibility of healthcare has been a deep-rooted plight plaguing the lives of millions of Indians, together, a difference can and will be made. Through proactive participation, active support from governments across the globe, and boosting global attention on this important issue, life will look very differently for the next generation of India.

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