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Planning Commission upbeat about medical tourism, grim on citizen healthcare

Medical tourism to India may have increased spectacularly in recent years, but for most ordinary Indian citizens healthcare services remain a nightmare. With this in mind, the government is formulating a health insurance scheme that will cover the country’s entire below-the-poverty-line population in five years

A high-level group of the Planning Commission in India reported in 2002 that as many as 150,000 medical tourists travelled to India, bringing in earnings of around $ 300 million. The number of people visiting India for medical treatment continued to increase by at least 25% every year since then, and the latest report by the Confederation of Indian Industries (CII) and McKinsey says earnings will go up to $ 2 billion by 2012.

The CII-McKinsey report, released recently by Planning Commission Deputy Chairman Montek Singh Ahluwalia, compared the cost of medical procedures in a few countries. For example, heart bypass surgery costs $ 6,000 in India, $ 7,894 in Thailand, $ 10,417 in Singapore, $ 19,700 in Britain and $ 23,938 in the US. Likewise, heart valve replacement surgery costs $ 8,000 in India, $ 10,000 in Thailand, $ 12,500 in Singapore, $ 90,000 in Britain and $ 200,000 in the US.

According to the Planning Commission, better quality medical services together with the low cost of surgeries are reasons why people from other countries, most of them from SAARC countries but also an increasing number from the United States and Britain, are flocking to India for medical treatment. The Indian government has also stepped in to facilitate visa procedures for medical tourists.

However, the Planning Commission paints a grim picture when it comes to healthcare facilities for the country’s citizens, admitting that all is not well in India’s public healthcare sector as it joins other nations to mark World Health Day.

The high-level group said in a report last week that public healthcare has been on a serious decline in the last two or three decades because of non-availability of medical and paramedical staff, diagnostic services, and medicines.

The Planning Commission has squarely blamed the shortage of medical professionals for the bleak scenario saying there was the need for at least 600,000 more doctors. The situation vis-à-vis availability of specialist manpower at community health centres is particularly bad. “As against the sanctioned posts, about 59.4% of surgeons, 45% of obstetricians and gynaecologists, 61% of physicians and 53% of paediatricians were not in position,” says the report.

The number of doctors registered by different state councils stood at 668,131 in 2006, resulting in a doctor-to-population ratio of 60:100,000. The state-wide distribution of doctors was also highly skewed, with certain states like Karnataka, and the union territories of Delhi and Goa having a favourable ratio while other states like Haryana, Bihar and Uttar Pradesh were underserved, the group said.

If the targeted doctor-to-population ratio is taken as 1:1,000, there is a requirement for at least 600,000 doctors. The group also drew attention to the acute shortage of dental surgeons in India. The number of dental surgeons registered in India stood at 73,271, against a requirement for 282,130 in 2007, it said. There is a similar shortage of nurses. While the ideal population of nurses should have been 2,188,890 in 2007, at present there are only 1,156,372 nurses.

Asserting that the overriding requirement in India is to increase the supply of human resources at all levels, from specialists to paramedical personnel, and to improve quality, the group, headed by commission member Anwarul Hoda, said this could be accomplished by opening up the medical education sector to private sector participation.

Private companies should be allowed to establish medical and dental colleges just as they have been allowed to open nursing colleges, he said. Other barriers such as land and built-up space should be brought down to realistic levels.

The recommendations, submitted by the group to Prime Minister Manmohan Singh, included asking the government to fill up vacant posts in order to improve the quality of teaching at government medical colleges and to enable these colleges to provide higher incentives.

A paramedical council for regulatory purposes and an institute of paramedical sciences should be established at the earliest to cope with the shortage of paramedical staff, it added.

Meanwhile, the government is formulating a health insurance scheme that will cover the entire below-the-poverty-line (BPL) population of 30 crore in five years, the Planning Commission disclosed in its report.

The insurance policy is taking shape following the recommendations of the National Commission for Enterprises in the Unorganised Sector (NCEUS). It has been estimated that the premium per family will amount to Rs 750, of which 75% will be paid by the central government and the remaining 25% by the state government. The cost of the smart card will be borne by the Centre; the beneficiaries will only need to pay Rs 30 per annum towards registration or renewal charges.

While state governments will determine the benefits that beneficiaries will be entitled to, the proposal is that hospitalisation expenses will take care of most common illnesses, all pre-existing diseases will be covered, and transportation costs up to Rs 1,000 will be covered, says the Planning Commission group.

Source: PTI, April 7, 2008
            The Indian Express, April 7, 2008
           Economic Times, April 6, 2008