Why is the role of the private healthcare sector critical in India?

India is poisedto be one of the top three health care markets globally in terms of incremental growth by 2020 as at an estimated CAGR of 22.87% (US$ 280 billion) from 2015-20, India’s health care sector is one of the fastest growing industries (The India Brand Equity Foundation Report 2017). This reflects immense scope for the expansion of health care services in India by both, the public and private sector. But these numbers do not reveal the challenges that the Indian health care systems are fraught with, especially in terms of regulatory, financial and operational issues. The Government provides universal healthcare services, free treatment and medicines, but public-sector services often fail to meet the growing expectations of our people in terms of providing quality healthcare, adequate number of beds for patients, infrastructure and clinical expertise required. Service delivery in the public sector is plagued by issues of access, regional imbalances, affordability and quality. Since it is under-served and under-consumed, sustained cost pressures limit affordability. This leads to massive out-of-pocket health expenditures, especially when health insurance coverage at roughly 25% is the lowest in the world.
 
Globally, the transformation of healthcare systems and improved health outcomes have been primarily driven by new technological advances. Thus, there is an urgent need for the creation of jobs within the public healthcare services via skill development initiatives to increase the penetration of technology and IT in healthcare and hence overcome the barriers to access in remote under-served areas. Quality standards also need to be established alongside requisite protocols and guidelines for healthcare delivery, diagnostics etc. The 2017 National Health policy shifts the focus from “sick-care” to “wellness”, by promoting prevention and well-being within the Indian healthcare system. It aims to increase government spending in public health care from the abysmally low 1.4% to 2.5% of the GDP. In such a scenario, private health care is a vibrant force that has boosted health care expenditure to 4.7% of the GDP, by accounting for almost 80% of India’s health care market. The private sector’s increased involvement in tier-I, tier-II and tier-III cities is expected to drive the Indian healthcare sector’s growth in the future.
 
Importantly, the presence of world-class hospitals and skilled medical professionals has strengthened India’s reputation as a preferred destination for international patients seeking quality care. India is a health care hub for those seeking world-class clinical care at affordable costs, by providing reasonable healthcare (tertiary and quaternary) facilities in compliance with international quality standards. Never the less, popular public perception is that the over-reliance on private hospitals allows them to charge substantially more than government hospitals. But this would be true for any other sector as well. Quality comes at a price. It would be useful to understand that quality private hospitals invest in infrastructure, technological know how, training of clinicians, quality drugs and other facilities and services that need to be upgraded constantly to prevent obsolescence. Several recent surgical advancements such as robotic-aided surgeries offering higher levels of precision subsequently cost more as they need specialized trained surgeons. Treating critical patients in ICUs involve the use of special attendants, facilities, consumables and round the clock management.Per bed cost is high in hospitals following global standards and protocols. This is also important as international patients form a sizeable percentage of those accessing treatment here.
 
For the sake of argument, one might say that the revenues of private healthcare delivery service have multiplied over the years but overall profitability margins are extremely low, given the multiple costs incurred.Opting for more expensive drugs, tests or procedures over cheaper ones by patients and their families similarly may also be driven by the need to expect a better guarantee of their scientific superiority. However, these problems reflect the overall lack of adequate regulatory frameworks within the Indian health care sector. Like Right to Education, Indian citizens need to have the fundamental right to public health. Parameters for effective health governance need to be put in place to facilitate uniformity, responsibility and accountability vis-à-vis the delivery of health care services.
 
Solving India’s health care woes requires rooting out the prevalent inefficiencies rather than simply berating the public or private sector. Incidents of violence against doctors highlight our inability to offer adequate protection to medical personnel. It is not fair to blame or brand an entire sector as a profiteering machineryas this would serve a wrong message. The Government must drive policy consensus at multiple levels to ensure that high priority is accorded to the development and enforcement of necessary mechanisms and guidelines to enable them to operate within an established framework.Moreover, capital flows should be encouraged to enable investments in the entire value chain of healthcare. The private sector’s massive infrastructure and capability for talent generation must be leveraged through collaborations and PPPs, to deliver the country’s healthcare needs and achieve our objective of universal health coverage, quality health services and improved health outcomes.
 
Aditi Rukhaiyar
November 29, 2018

source https://indiaoutbound.org/why-is-the-role-of-the-private-healthcare-sector-critical-in-india/