State of Healthcare in India - Additional Inputs

Dear Friends:

Since October, when we had submitted our whitepaper on Healthcare Reforms, both the Health Minister and Health Secretary have changed.

Therefore, we would like all of you to review the key issues, root cause and solutions listed below to make the Healthcare System in India better and share any additional inputs you might have.

We will be submitting the amended whitepaper to both the new Health Minister and Health Secretary for their review and actions.

I look forward to your participation!
Rajendra Pratap Gupta

-------------------------------------------------------------------------------------------------------------------------------

Improving Healthcare in India

Issues identified:
1. Medicines and medical tests are getting expensive day by day
2. A nexus has developed between the hospitals/doctors and the path labs
3. Hospitals prescribe costly medicines which are never given but only billed
4. They charge for very costly tests which are either not necessary or not done & false reports generated by computerized forgery
5. The surgeons overcharge
6. Many surgeries are done by trainees under a senior doctor’s name
7. No standardized rates displayed in hospitals for the services offered
8. Doctors don’t prescribe generic medicines which are much cheaper
9. Generic medicines are hard to find in the market
10. Lots of cases of fake medicines are being reported
11. Absence of senior doctors from government hospitals
12. Patients are misbehaved with in government hospitals
13. Entry and exit formalities are very poor in government hospitals
14. No complaint redressal mechanism in government hospitals
15. Prescribed medicines are available only in the nearby stores and not around the city
16. Hospitals run their own Pharmacy & make it is compulsory for indoor patients to buy medicines from there
17. Reimbursement of medical bills by insurance companies is another big issue
18. Patients are prescribed unnecessary tests to get kickbacks
19. Modern treatment facilities are not available in public hospital
20. No Transparency in treatment
21. Patients are kept in ICU for getting higher room rents
22. Treatments are extended for indoor patients for keeping the beds occupied and maximizing returns
23. If a patient has mediclaim, he is charged extra compared to a patient without insurance cover
24. Unhygienic conditions prevail in most clinics/ hospital complexes
25. Dubious clinics still carry out unauthorized organ selling, surrogacy, abortion of the girl child, etc.
26. All health centres and Super specialities are in cities. Rural population cannot afford these
27. Banned drugs continue to be available in the market
28. Little or no medical facilities in most villages
29. Red-tapism in the CGHS system
30. Uneducated and untrained Doctors are a big problem
Root Causes identified:
1. There is no governmental control on drug prices
2. No laws to govern the working of path labs
3. There is no rule to govern the rates of medical tests across path labs
4. Private colleges charge a hefty donation for admissions. Doctors hence use alternate ways to earn and get return on this investment
5. Doctors try to make extra income by tying up with these path labs
6. Doctors get perks from the pharma companies for prescribing their medicines
7. Hospitals want to make more and more money from the patients
8. Surgeons are allowed to decide themselves how much they want to charge for surgeries, depending on their seniority
9. Generic medicines have a lesser margin and hence chemists don’t like to stock them
10. The huge number of people who turn up at the Government hospitals make the Doctor’s/Staff’s job very tough
11. Insurance companies try to find the smallest flaws in the application to be able to reject claims
12. Doctors don’t want to work in villages since they lack infrastructure
13. Not enough awareness among general public about medical practices
14. Not enough good medical colleges in the country to produce the required number of Doctors
15. Medical practitioners in general lack humane attitude and use their expertise only for earning money
16. Anti-competition laws are ineffective


Solutions identified:
1. Better cleanliness and hygiene should be maintained in government hospitals
2. Emulate British health care system where every citizen has to contribute a part of the salary as social benefits and money is distributed for state and central healthcare system
3. A low premium based Health Insurance Policy covering all citizens of the country and the drive should be in line with opening of bank accounts Jan Dhan type
4. Nationalise all private medical colleges and pay professional salaries and campus residence for all professors and teaching staff
5. More government medical colleges should be opened
6. Affiliation of the colleges charging donation should be cancelled
7. Consultation fee of the doctors should be fixed by the government
8. Medical representatives visiting the doctors should be made illegal. They should be handled by the admin staff
9. The price list of different medical procedures should be displayed in the hospital premises
10. The working of all the path labs should fall under a common law
11. All Medical tests should have maximum standard rates for every state which needs to be approved by a standard govt. body and displayed in every hospital and clinics as a mandatory rule Increase in prices should be allowed only through some governmental body and its approval
12. The licences to the Public Analytical Laboratories should be given after thorough scrutiny and so also their renewal should be thoroughly audited
13. Generic medicines should be easily available on counters
14. A social campaign should be created to educate the masses about medical practices
15. .A regulatory body for Professionals (Doctors in this case) beside IMA which is just like Cricket Association leaving no scope for Government to directly intervene
16. Time frame & timely settlement of health insurance claim which may include negligence of Doctors, wrong medicine prescription etc.
17. There must be master agenda to upgrade the overall status of the rural and sub-urban hospitals/health-centres. This will also help the crowd to stay away from the crowded cities
18. Proper supply and honest distribution of free medicines/supports in the hospitals must also be duly taken care of
19. Negligence should be treated sternly
20. Encourage the big business houses who can afford the huge expenses of running the medical colleges
21. Give free tuition to 50% students if they agree to work for 5 years in rural India on stipend after passing out more  

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Ravi Ramesh would like to connect on LinkedIn. How would you like to respond? Accept: https://www.linkedin.com/e/v2?e=-3p28t-iexy65fv-t&a=preRegInvite&ek=second_guest_reminder_01&li=3&m=hero&ts=accept_text&sharedKey=wL5wXpyN&invitationID=5984256920637181952 View Ravi Ramesh's profile: https://www.linkedin.com/e/v2?e=-3p28t-iexy65fv-t&t=npv&ek=second_guest_reminder_01&li=4&m=hero&ts=profile_text&memberID=187700212 You received an invitation to connect. LinkedIn will use your email address to make suggestions to our members in features like People You May Know. Unsubscribe here: https://www.linkedin.com/e/v2?e=-3p28t-iexy65fv-t&t=lun&midToken=AQFmrFVhGEd36Q&ek=second_guest_reminder_01&li=8&m=unsub&ts=HTML&eid=-3p28t-iexy65fv-t&loid=AQFxu7KgLvfV1gAAAU__e2GvlfGib6jYCF4ge1-piZJUeP7GXwnEiRZXjmX7QIlZS9qdUOVLOKHeANyorjtJjG3HMTq5Guq4zygOLqp3Pszxx7VT6hE_zvy9sbGrqhxKQvJPXW9Vtr-5_3r-ZGd45ZSJ This email was sent to www.send_liked_post_email++mqqsfdbbvvqs++fdlklkgxfdlk@localcirclesmail.com. If you need assistance or have questions, please contact LinkedIn Customer Service: https://www.linkedin.com/e/v2?e=-3p28t-iexy65fv-t&a=customerServiceUrl&ek=second_guest_reminder_01 © 2015 LinkedIn Corporation, 2029 Stierlin Court, Mountain View CA 94043. LinkedIn and the LinkedIn logo are registered trademarks of LinkedIn. more  
For healthcare, a decision support system (DSS) can be helpful in many ways. More info at, www.ncbi.nlm.nih.gov/pmc/articles/PMC3116253 more  
Most problems and solutions can be divided into a few broad categories - problems of quantity (lack of doctors, lack of health facilities in rural areas etc.), problems of quality (no quality in govt. facilities, quality not at par with costs in private facilities etc.), problems of regulation (no regulation of prices, no regulation of private sector, no accountability in govt. facilities, no regulation of professional bodies etc.) As mentioned in point 2 solution, we need a Universal Health Coverage (UHC) for all people in India based on the European models - first started by Germany but now almost all European countries have it. Closer to India, Singapore, Taiwan etc. have it too. In India, UHC is being postponed with the excuse that we are poor, we don't have the money to do it etc. But we must know that when Sweden or UK rolled out UHC, it was after World War 1 and World War 2 respectively, when they were poor had faced a lot of destruction and loss of lives. This only requires political will and it can be done. Without ensuring health and education of Indian people, we can never even dream of being a developed country. Everything else might drive our GDP growth for sometime but unless public human welfare issues are addressed, this growth cannot be sustained. Every solution we otherwise apply will be just a band aid for a massive cancerous tumour. But still the most important solutions till we have UHC will be: 1. Improve the quantity of doctors and hospitals (open more govt. medical colleges and hospitals - 1 medical college in every district of India should be the target - we also need more doctors. Right now medical colleges are being opened privately, mostly by politicians and businessmen and they have just become a way to earn lots of black money at the expense of Indian people. This needs to be changed). 2. Even AYUSH doctors must be allowed to dispense primary healthcare including prescribing primary level allopathic medicines and conducting deliveries. We have 6 lac allopathic doctors in India and also 7 lac AYUSH doctors. We must integrate the systems at all level beginning from college education. 3. Improve quality of services - mainly in public health sector using Indian Public Health Standards. 4. Regulate private sector to reduce prices and to improve quality (although once public health sector improve, private sector will have to improve due to competition - main reason why even after paying money you can't get good healthcare in private facilities) 5. Health insurance must be made mandatory for all in a phased manner. One can begin with cities and the organized sector followed by other parts and populations of India. Health expenditure is the biggest cause of poverty creation in India after farming debts and this needs to change. more  
Famous annual festival in Khatu from 24 Feb to 2 March attracts 30 Lac+ people. HOLY PLACES NEED DEVELOPMENT especially roads, infrastructure, healthcare, education, tourism, hospitality etc. I hope the Central & State Governments allocate some part of their budget for development of religious places like KhatuShyamJi. In Northern India (Khatu Gram, Sikar District, Rajasthan), one of the famous annual festivals held every year is 'Shri Khatu Shyam Falguni Satrangi Mela 2015'. It will be celebrated from 24 February to 2 March 2015. 30 Lac+ visitors are expected. Legend / Story behind Shyam Baba (English, Hindi), English Version : www.khatushyam.in/full-story-of-khatushyamji-1.php Hindi Version : www.khatushyam.in/khatu-shyam-ji-hindi-story.php Location of the temple of Khatu (in Sikar district of Rajasthan), www.khatushyam.in/location-of-khatu-shyamji.php www.khatushyam.in/khatu-shyamji-map.php Details of Festival @ below pages, www.khatushyam.in/festivals-of-khatu-shyamji.php www.khatushyamjimandir.com/Aarti-Timings.htm www.khatushyamjimandir.com/news.htm List of few other famous temples of Shyam Baba, www.khatushyam.in/khatu-shyamji-temple-lists.php more  
Its sad disappointing health secy is giving a Deaf ear to Public complaints specially CGHS is one field which is terribly hit by Faulty decisions since change of rrgime and Believe me these played a key role in Defeat of BJP in delhi Vote shift all my Letters Suggrstions were sent to dusbin Even writing to PMO did not solve problem Plz examine why Helth Secy ignored including the new as more  
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