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‘Healthcare today is not a Business Opportunity but it’s a Trap’

Dr Kunal Sarkar talks about the massive transition that has taken place in the healthcare sector, the swelling expense of the tertiary healthcare sector and the challenges that lie ahead. Excerpts:

The Indian healthcare sector is expected to reach Rs 19,56,920 crore (US$ 280 billion) by 2020. Rising income level, greater health awareness, increased precedence of lifestyle diseases and improved access to insurance would be the key contributors to growth. Health insurance is gaining momentum in India

 

 

How’s the healthcare climate of India:

Indian healthcare domain is witnessing a massive transition. From a feudal, constricted system, it has now bloomed into an ultra-modern, edgy and service-oriented industry that has curated care models to bring healthcare at the patient’s doorstep. We have opened the floodgate and the biggest challenge is to meet the medical needs of 120 million Indians.

Our nation has grown into a mega factory of skilled manpower. The lawmakers made some excellent decisions in the past that cemented the future of this country. India has shown formidable growth graph in the field of technocracy, medicine and medical education. We are much ahead of many cash-rich countries such as Saudi Arabia, Nigeria and Brunei as they have ample money power but we have overflowing skilled workforce that has laid the foundation of a strong economy after Independence.

Is healthcare a commodity or a service?

We are at a vantage point as the nation is basking with young talent, but we are also facing an immense challenge to keep quality healthcare affordable. The entire healthcare system is struggling to find the right balance between commoditization and service. The government-aided healthcare delivery is still frail to support the requirements of the people and private healthcare is sleek but it is still far away from the reach of millions of Indians. As a democracy, we must build a strong and affordable healthcare ecosystem. Our politicians and lawmakers must understand the writing on the wall. We, as citizens, have the right to life but our Constitution hasn’t given us the right to quality healthcare. Healthcare is a priority for the country and government has undertaken some hefty steps to restructure the healthcare skeleton of the country. By following the footsteps of the Government of India, several state governments have rolled out healthcare schemes. These schemes have suddenly made quality healthcare accessible in India.

In a nation like India, the health-care burden is not evenly distributed between the private and the public sectors

Is the private healthcare system struggling to cope with populism?

Healthcare today is not a business opportunity but it’s a business trap. The thriving healthcare economy is struggling with sentimental policies that are fluctuating like the weather. We are standing at the crossroads and still fighting to get our foothold. The government must frame proper and strong policies by brushing aside populism to support the inflow of FDI (Foreign Direct Investment) in this segment.

The hospital industry in India stood at Rs 4 lakh crore (US$ 61.79 billion) in FY17 and is expected to reach Rs 8,60,000 crore (US$ 132.84 billion) by FY22.

 

Like pizza and biryani, should healthcare be available at our doorstep?

In the last few years, the healthcare sector of India has attracted the attention of many international players working in this sector. Malaysia’s IHH Healthcare has scalped 31.1 per cent stake in Fortis for Rs 4,000 crore after months of intense competition and is in process of taking another 26 per cent stake. Besides, KKR-backed hospital management firm Radiant Life Care has already completed the acquisition of Max Healthcare Limited. But somewhere, the entire canvas is not satisfactory to stimulate the growth of the sector because in the last 10 years there has been a very feeble real-time capacity expansion.

Are the doctors competing for numbers:

We are producing doctors in numbers and to meet the rising demand of the market but we are not producing doctors as per the demand of the infrastructure. India is producing approximately 30,000 doctors every year and 50 percent of this population is purchasing their future with money. These doctors are foraying into the medical arena with a whooping loan of Rs 3 to 4 crore on their shoulders. They are working in an extremely competitive atmosphere and they don’t have predictable employment. Under these circumstances, they are bound to work like a mule and earn money to secure the future of their family. They are running behind numbers and not quality service.

The Government of India approved the continuation of National Health Mission with a budget of Rs 31,745 crore (US$ 4.40 billion) under the Union Budget 2019-20.

 

The government must handpick apt and suitable healthcare strategist/s to change the present scenario of healthcare in India. Your take:

The healthcare policies in India are often scripted by the babus who have minimal knowledge about the entire sector. That’s why most of the policies often lose steam with time. However, a few of the government-backed institutions, such as NITI Aayog, is doing some excellent work in the field of strategy and planning. Public Private Partnership (PPP) must be strengthened to change healthcare skyline. Block-level strategies must be rolled out to enhance the outreach of quality and affordable healthcare to the rural population of the nation. If we could boost the overall primary and secondary healthcare system, then we can easily arrest the swelling expense of the tertiary healthcare that the state government often has to bear.

Can the government negate the participation of the private sector in healthcare policymaking?

In a nation like India, the health-care burden is not evenly distributed between the private and the public sectors. Presently, the private sector bears the load of the healthcare sector of India. So, while drafting the policies, the government must consider the opinions of experts from the same sector. We must work hand-in-hand to build a better healthcare ecosystem in India.

In the coming days, the government must decide whether it would be an insurance provider or an infrastructure provider for the larger population. Your take:

It’s high time that the government decides its stand — whether it would love to stay as an infrastructure provider for the people or an insurance provider. For example, the entire banking sector changed with the nationalization move. So, in the healthcare sector, the government must understand the priorities and determine its stand before capping the prices of the implant devices and flooding the market with fair price medicines. However, I agree that these reform moves have considerably flushed out the nefarious elements and paralyzed the nexus of evils active in the healthcare domain. Either the government should work with the proper national healthcare policy and shoulder the burden of the healthcare or must they must tag healthcare as a commodity or a service.

An investor has to pump in more than Rs 40 core to build a full-scale medical facility and have to incur massive losses before reaching the break-even point.

Several countries like Japan, Korea, Singapore, Taiwan and Thailand have successfully implemented the national healthcare policy to restrict commodification of the healthcare sector. We, as a nation, must think about the national healthcare policy to stop the malpractices that have crawled in this segment with time.

Healthcare in India is on the cusp of significant transformation — demographic, regulatory, technological and financial — Organisation of Pharmaceutical Producers of India (OPPI) President A Vaidheesh said in a recent interview.

 

Do you think the private healthcare sector in India has survived through troubled times?

The private healthcare sector in India has struggled through troubled times since we are fighting multiple challenges and very few will survive through this storm. I believe, only the government-backed healthcare institutions will stay afloat.

The boom of healthcare tourism is like Hima Das winning gold in the 200 metres. Your take:

I think the growth of healthcare tourism in India defines the strength of the healthcare sector in India and it is the outcome of an abrupt growth of the healthcare system as a whole in the country that started in the 1980s by the government-backed healthcare institutions such as Mumbai Municipal hospitals, Railway Hospital in Perambur, in private Apollo Hospitals played a crucial role to cement the future of the healthcare sector. Today, we are delivering quality healthcare to entire Central Asia, Africa and the Middle East.

 

 

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Subhajit Bhattacharya

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