Some thoughts on Health Care in India

By Santanu Pal B.Tech(Hons.), MSIE (Wisconsin-Madison)

Maslow’s Hierarchy of Needs, a well known model in Management Studies, states that the first step in the hierarchy is physiological needs of an individual. Physiological needs include food, shelter, health care etc.

At the University of Missouri-Columbia, Prof. ‘Art’ Jago, told us that he believed that the first two steps in the hierarchy of needs is the responsibility of the state, to provide adequately – the second step being security. I believe this also.

Given the state of most government treasuries in India today, and the cost of modern health care, it is unlikely that the state can meet its responsibility to its citizens adequately in the near future. Therefore private sector health care may be permitted for the time being – whilst taking care that the public sector is not marginalised in the process. E.g. public hospitals too must be eligible for payouts from insurance companies as per a common payment schedule for any insured patients that they treat.

Also the cost of health care varies widely across India. To account for regional differences state governments must be allowed to co-opt[1] (add) payments to the central Payment Schedule. (E.g. the govt of Delhi can pay an extra amount to pay for higher cost of healthcare in Delhi. They can recover this sum from taxes on Delhi businesses, including profitable hospitals.) This would also avoid the embarrassment to the central government of publishing different payment schedules for different parts of the country.

Finally the private sector too should be allowed to contribute to, and be roped in for National Development. (Some of the most successful businesses have been public-private partnerships e.g. conquest of the West (America) by private railroads on government donated lands (more on this later)). E.g. for an essential service, such as polio immunisation, why should a family, normally accustomed to treatment and hospitality at Seba, have to queue up at a public dispensary? They should be able to get the necessary immunisations at Seba itself. Seba can then be reimbursed as per a national average cost, by the state or insurance companies. If insurance companies believe that today’s insured children will grow up to be tomorrow’s paying health insurance policy holders, I think they will find it quite worth their while to pay for immunisations and other preventive health care.