Health Care System In India Health And Social Care Essay

India is a pluralistic, multi-lingual and multi-ethnic nation which accounts one-sixth of the world’s population occupying less than 3% of the world’s area. In India, since the last 10 years considerable work has been undertaken related to health and hospital sector reforms, which has involved various government, worldwide multilateral agencies and other stakeholders. Delivering affordable health care to India’s billion plus people presents enormous challenges and oppturunities for the medical community. The practice of medicine is becoming increasingly complex and time consuming. Political ideologies play a major role in determining the health policies of the country through decisions on resources allocation, choice of technology, human resources policy and degree to which health services are to be made available to the population.

No health care system in the world is stable. To start with health care sector has to become the priority sector for the government of india.The Indian health care sysyem must have a broader scope and biggert purpose.The government of india has taken a smart fight against HIV, T.B, Tobacco.The launch of massive programmes like The National Rural Health Mission (NRHM) and National Urban Health Mission(NUHM) by the government of india and ban on smooking in public places is a proof that Indian government is committed to health care of its population.

To start by the fact that higher spending does not mean better health care . We have the case of America where 17% of the GDP goes on health care , still 77% of Americans have at least one chronic disease(1 out of 2 americans have a chronic disease and 7/10 people die of chronic disease).So we must not pursue wrong goal of just doubling the health care spending as a percentage of GDP. India is a young nation with 60%of its population below 40 years of age therfore We need a system that is outcome driven.Its high time that we converte our slogan from food, clothing and shelter to food, clothing and health care.

According to WHO, India has 14% of its population suffering from arthritis(approx 140 million), 10% suffering from Hypertension(approx 100 million).Accroding to international iabetes federation, approximately 5% of Indian population suffers from diabetes(50 million) and elderly people in india accounts about 150 million.

I believe that we have been already been late for this generation but we must build a robust healt care model for coming generation.We need to bring change in government policis,medical curriculum and channels to delivery of care across health care spectrum.

Constraints and challenges in health care sytem

Problem of distribution

India has a serious problem with focus and allocation of health resources, we are quite urban centric. Asurvey by Indian medical society had found that 75% of the qualified consultant doctors practice in urban centers , 23% in semi urban ares and only 2% in rural urban ares(where 65% of the toatal population live)

Preventaive care

The problem of not adopting a preventive health care is that aging population requires more health care treatments with lower earning and paying capacity. Earnings reduces with age but health care problems increases and this will put young nations of today into serious economic and developmental crisis in the next 20 years.

Financial constraints

Health expenditure was 5.9% of the national budget in the year 2009 compared with 7.6% in 1990 and 8.4% in 1985. The running cost of extensive health care infrastructure is high and can not be met with the current level of expenditure. Moreover Investment in medicine and human being support is required to fortify national capacity for first-class manufacturing practices in order to produce essential drugs, vaccines and medical supplies. Health is largely financed by the private sector. Per capita public health expenditure is nearl20 Intl.$ per annum. Due to inadequate budget and pressure to achieve targets, several states upgraded two-roomed sub-centres to full PHCs. With limited space for laboratory, examination, pharmacy, etc., many are not fully functional. Location also is a problem. Nearly 25% of the people in Madhya Pradesh and Orissa could not access medical care for locational reasons.

Expertise and other physical constraints

After 62 years of independence essential expertise such as handling medical emergencies , complications of pregnancy and childbirth, treatment of acute and severe infection in children and In aged patients , injuries and acute surgery, are sometimes compromised because in India, a basic medical degree without a specialization is of not much use and there are so few graduate specialization seats that competition is fierce. In addition, the problem is getting worse day by day : expertise in India are leaving medical schools for better-paying jobs in private hospitals and in the biotech and pharmaceutical industry, forcing the medical schools to cut the size of their programs. And students who would have studied medicine a generation ago are pursuing more lucrative careers in the technical sector. Hospital infection control procedures require strengthening and even Work place wellness (Occupational health) is not established in india.

New paradigm of health care

Government action

We need a central health authority along with state authority in every state to focus n Health Risk Managemant., Health awareness, Mother and child care , Occupational health and Disease management.Government should hold the sole responsibility for awareness creation about wellness and disease sepeartely and both should be handled by different departments .

India also need an epiddemological survey as wee need to be more scientific in whatever we do to have an outcome.Moreover all the admissions after high school should have a basic health check up as prerequisite and marriage certificate should only be issued after comprehensive risk management.Furthermore government should start a 24 hors health channel Day acre centers for minor surgeries.

Chronic disease

Chronic disease cannot be controlled by prescription alone.I t involves behavioral and life style change and this calls for counseling. Moreover doctors, Pharmacists and Nurses should be trained in the treatment and dealing of chronic diseases. In addition to that patient’s family should be involved and government should immediately start a Central/State disease registry so that patients must be registered under the same by path lab itself.

Finacial incentives in health Crae

Telemedicine hold a promise when it comes to health care delivery in more than 3billion villages. Appolo hospitals just launched a telemedicine service , a combination of technology, telemedicine , preventive health care , training of the district health care workers and their doctors by going out , travelling overnight by train or by car in the rural area , conducting free medical camps and voluntary organizations , operating in theaters over there or doing consultations .Such companies and hospitals should be given tax rebate and health professionels working in rural india should be given 50 or 100% tax free income based on the regional disparities. Pharmaceutical and other biotech companies that sponsor health checkups in the communities should be given 50% tax rebate.

Medical curriculum

Far reaching requires changes even in medical curriculum.The government should not allow MBBS doctors to do post graduation till they spend 2 months each in rural health, Panchayat health centres and pharmacies. Moreover doctors going in rural area should be given loans at cheaper rate .

Public private parternship(PPP)

Public –private cooperation should be made at secondary and tertiary care. The effort to cure infectious diseases that kills millions of people around the world require both a push and pull mechanism to engage the private sector with government in sustainable solutions. Government can provide some money to "push" discovery and development of various drug and vaccines in India that biotech and pharmaceutical firms would otherwise tend to disregard and overlook. However companies necessitate to recognize that they will be awarded if effective treatment or cure is acknowledged. The "pulls" can be generated through a number of public private paternships that seek new behavior to create viable markets for pioneering health care services and products. This will provide scientific creditability, optional solidity and stability , Finacial feasibility and political viability.

New models

The government must ideate and try new low cost models where the primary preventive care can be availed at Rs 2(INR) per day.Imagine , if we get 5000 people to pay Rs 2 a day, we can achieve Rs 3 lacs per month per facility and this can be used to have two full time doctors, two nurses and two counselors to provide basic care to the population of 5000 people around the clock.

Therefore we need to find new models and steps for inclusive growth in health sector in India. very minority number of hospital groups are economically smart and overseas direct asset is going into every other sector in india and not so much in healthiness care.We have to decentralize the key element of reform process and set in motion the concept of PPP into newer magnitude by receving Pollicy attention in a major way. Today’s sculpt of health care are not solutions for tomorrow’s health care troubles. Private sectors should be seen as a national assest and alternate service delivery systems should be considered.