By Raavi Aggarwal
In most developing countries across the world, effective healthcare delivery poses a challenge. A conglomeration of factors including misallocation of funds by the government, improper regulatory mechanisms and diverse socio-economic viewpoints have prevented the poor from gaining universal access to healthcare at affordable costs. Despite inexpensive knowledge transfer of technological advancements in medicine across countries, the institutional frameworks of underdeveloped countries are unable to implement cost-efficient methods of healthcare delivery. Over 5 million children die before the age of five, worldwide, from a host of easily preventable or treatable diseases such as Malaria, Tuberculosis and others. Approximately 25 million children do not receive essential vaccines at the requisite age. Public health administrators have surely missed something, for on the one hand, the most advanced technology such as MRI scans, stem cell research and human genome research is being used to treat hitherto life-threatening diseases, but on the other hand, children in developing countries are dying of food poisoning and malaria.
The inadequacy of healthcare delivery services in India in both the rural and urban sectors is evident. However, rapid advancements in technology and inward FDI in the healthcare sector have precipitated growth in this sector and contributed significantly to the increase in life expectancy in India (presently 67.3 years for Males and 69.6 years for Females). However, the disease of corruption has permeated to every nook and cranny of the country, even to the “noble profession of medicine” as it was once called. While private hospitals provide better facilities and treatment options than government ones, their under-regulation by the statutory body, Medical Council of India, has resulted in the proliferation of surgeries that violate the Code of Medical Ethics. In fact, the former President of MCI, Dr. Ketan Desai was devolved from his position in 2010 following allegations of accepting kickbacks to grant recognition to a medical college in Punjab. Thus, in effect, with no government supervision over corporate hospitals, one can never guarantee the credibility of prices charged for doctors’ consultations and surgeries. Admittedly, medical equipment, particularly surgical transplants have high costs, but the distribution of the total cost of an operation is highly skewed towards the hospital administration and owners rather than the doctors whom patients place their trust in.
Not only do hospital administrators charge exorbitantly for every minute procedure, but also coerce doctors to expropriate large sums of money from patients by indulging in unethical consultations. When a patient approaches a doctor claiming leg pain, instead of advising a course of antibiotics, he will straightaway be booked for a surgery, which is inevitably costlier. The corporate businessmen running private hospitals look only at a doctor’s revenue generation, rather than the quality of service being provided. This malpractice strictly opposes medical ethics, based on which a doctor is duty-bound to advise the most appropriate course of action in case of an illness. A rather shocking revelation is that of “shadow” surgeries-when a different doctor than the one a patient sought consultation from, performs the surgery. This occurrence strongly violates moral principles on which the practice of medicine is based. It violates a patient’s trust in the doctor. Moreover, the prevalence of under-qualified doctors is another dereliction that leads to a tremendous loss of lives. Yet no regulatory authority seems to be vigilant enough to curb this apathetic attitude. However, merely blaming the doctors will lead to an impasse.
Economic theory informs us that rational individuals respond to incentives. Then who can blame a doctor for wanting to enhance his monthly income by responding to incentives and bonuses as provided by hospital authorities? While such an approach intuitively means no harm to society, compromising medical ethics certainly does. Doctors ought to ask themselves why they took up the profession in the first place. Was it to provide a real service to the public or to expropriate money from their patients? In addition, hospital administrators ought to ponder over what good they are truly providing to society. Rather than ensuring affordable healthcare in a country that is in dire need of it, they are robbing society of its resources and precipitating tremendous economic and social inequalities. Moreover, the apathy of the government in monitoring activities in the medical field has made the situation uncontrollable. Doctors’ salaries are reduced and patients are ill-advised, while hospital owners sit comfortably in their luxury suites. The medical profession has been converted into a typical corporate business-striving for profit, not providing a service. However, with a slight change in their attitude, hospital owners, together with government policymakers could provide cheap and accessible healthcare facilities to each and every citizen in the country. Every businessman could learn from the noble words of Henry Ford, one of the greatest businessmen, who was instrumental in bringing about the Great Industrial Divide.
“A business absolutely devoted to service will have only one worry about profits. They will be embarrassingly large.”- Henry Ford
- “Improving Health Care Delivery in India”, Banerjee and Duflo, (2009)
- India-Data on Life Expectancy, World Bank
Raavi Aggarwal is a third year student of Economics at Miranda House, with an ardent desire to pursue Development studies at the postgraduate level. She is a fervent advocate of socialist economic planning and believes human resource development is a prerequisite to mitigating poverty in developing countries. Apart from academics, she is a zealous lover of the performing arts and is herself engaged in Western Music (Violin) and Jazz and Contemporary dance.