Source: E-mail
dt.26.6.2011
Management of
Healthcare in India: Some Issues and Challenges
Dr.K.S.
Srinivasa Rao
Director,
Institute of
Health Management Research (IHMR),
Bangalore,
India
Introduction: The saying “Health is Wealth” even
though it was a old one, but is a needy one in today’s changed environment due
to various reasons.
World Health
organization (WHO) was defined Health as a state of complete physical, mental
and social well-being and not merely absence of disease or infirmity. But after four decades, it re-defined
Health as a resource for everyday life, not the objective of living by
emphasizing social and personal reasons as well as physical capacities
[1].
Basically,
Public Health deals with Prevention of Diseases, Prolonging Life and Promoting
Health through the organized efforts.
The country has well structured 3-tier Public Health Infrastructure,
comprising Community Health Centres, Primary Health Centres, and sub-centres
across rural and semi-urban areas and Multi-Speciality Hospitals and Medical
Colleges located at urban areas.
The National Health Policy-2002 aims at achieving an acceptable standard
health for general population of the country and it was reflected as the main
objective in Eleventh 5-year Plan [2].
Healthcare deals
with treatment and prevention of illness.
The Healthcare Sector includes the Hospital Management Firms, Health
Maintenance Organizations, Biotechnology and a variety of Medical Products. Alternative Medicine is a traditional
healing practice like Naturopathy, Herbalism, Ayurveda, Meditation, Yoga,
Hypnosis, Homeopathy, Acupuncture that doesn’t fall within the realm of
conventional Medicine but popular in the society [1].
The Healthcare
Industry in the country has registered a growth of 9.3 percent between 2000-09
and is projected to grow 23 percent per annum to touch US$77 billion by 2012
according to the market studies [3].
Both public sector and corporate India are making their efforts to meet
the demand by expanding their business horizons and to grab the market [4]. This scenario attracted Foreign Direct
Investments (FDI) and also leading to Mergers & Acquisitions in Healthcare
Sector that pulled the competitors to different directions
[5].
Impact of
Globalization: Liberalization,
Privatization and Globalization (LPG) has its impact on people in India and
shown the other side of the coin by giving a good image about our country among
the foreign nations. We should
proud to say that the Image of our country among the foreign nations has changed
from a “Poor Country” to “Knowledge Hub”.
The author
attributes mainly “5- I” Factor for such a facelift to the country – (1)
Information Technology [IT] usage, (2) Innovativeness in Businesses, (3)
Intuitiveness in controlling the Economy, irrespective of political changes in
the Government, (4) Inquisitiveness among people due to the free environment
created by implementing the freedom by all means approved as per Indian
Constitution and (5) Inherent Intelligence among the people because of the
traditional culture and heritage of the country.
The penetration
of IT usage made India a global business unit and made on-line business as the
order of the day. IT became a
backbone to all businesses and used as a cost cutting strategy in order to
withstand the competition. IT
sector created employment opportunities and forced the Educational sector to
meet the demand by adopting new curriculum.
The businesses
in India in different sectors are able to sustain to the global competition
because of their innovativeness and creativity. Because of innovativeness by the Indian
Entrepreneurs, new products are coming into the market. Indian businessmen are
competing with foreigners by entering into global bidding and acquiring foreign
markets. We can proud to say that
Indian business companies are listed in foreign stock markets and doing a very
good business. “Made in India” became a serious business
perspective.
India is one of
the Democratic countries in the world where political changes will affect the
Economy. Even though world
economies were collapsed, India was able to withstand during the recent global
financial crisis. The Intuitiveness
in controlling the Economy saved our skin inspite of lot of uncertainties in
Indian politics and this is because of its conservative attitude that was
inherent.
Inquisitiveness
among people made India to be in the global market in different sectors be it
Space Research or be it Bio-Technology.
Inquisitiveness comes only when the free environment is created and it is
because in India we respect the Constitutional Rights. One can notice that in any country where
Constitutional Rights were not respected, the growth was not
significant.
Even though we
give credit to fertilizers and manures used, when productivity of a crop is
high, but basically it may be due the fertility of the land. Similarly, the people in India have
shown their Inherent Intelligence in various fields of development and made the
country to be proud of them. This
is because of the traditional culture and heritage of the country makes people
to follow good practices in life which leads to a peaceful
life.
The Role of
Urbanization: Urbanization made India to shift its
focus from Agricultural Sector to Manufacturing Sector and now to Service
Sector. When we opened our
economy, we invited not only the international businesses but also the issues
related to them. People were
enjoyed when job market was open due to Outsourcing Business but people were
realized later how it affected the life styles of them. Society has shifted from single-earning
member to duo-earning members and this had a positive impact in changing their
Economic status from lower middle class to upper middle class but has a negative
impact on personal front as they may be unable to adjust to work-life
balance. As people are unable to
find time for direct social interaction, on-line social networks became
popular.
The change in
the life styles brought new health problems to the people in India. Fast food centres became more popular as
people unable to find time for their own preparations. Work pressure on employees has increased
due to the competition in businesses.
Hypertension, Heart Diseases, Obesity became common even among the
young-age people due to the stressful office activities. Buying power of people has increased due
to plastic currency (credit cards) usage and flexible EMIs of Bank Loans. Traffic congestions increased due to
increase in vehicle frequency but the road conditions are not improved in the
same pace. Pollution levels have
increased in each city and other diseases due to pollution increasing. The civic authorities are not able to
manage the local governments due to the rapid growth due to urbanization. This made the governments to work not in
an isolated way but by networking with Private and NGOs with the concept of
Public, Private Partnership (PPP).
Healthcare
became an emerging sector and is making a good business in the market. The awareness regarding healthcare among
the people has increased. In fact,
the Healthcare businesses made it by creating the awareness. To overcome from the problems related to
change in life style, alternative medicines become more popular and this may be
a kind of blessing in disguise.
Morning Joggers, Gym visitors, Yoga followers, Ayush Care Centres, Body
Slimming Centres became the order of the day. This scenario attracted a good
business in Healthcare sector and private sector taken the opportunity and
grabbed the market. This made some
foreign agencies to look at India and entering in Indian markets by Foreign
Direct Investments (FDIs) and also grabbing the Indian businesses by Mergers
& Acquisitions.
Development of
Science: The development of Science has a role
even in Healthcare sector from Drug Discovery to Delivery. The R & D labs are in collaboration
with foreign companies and introduced new technology, modern instruments and new
drugs. Interesting point is that
two decades back, may be due to lack of awareness, people used to suffer with
diseases like Tuberculosis (TB), Leprosy, Cancer etc. but today due to increase
in awareness, we are able to identify diseases AIDS, H1N1 Virus, Brest Cancer,
Prostate Cancer, Superbug etc.
Affect of Global
Warming: Everybody experiencing the affect of
Global Warming directly or indirectly.
One side the average life span has increased due to good health practices
and but due to natural calamities interms of Floods, Earthquakes, etc. heavy
losses to human life is happening.
If natural calamities are God created in one side, the level of these
activities are intensified due to man-made issues like cutting the greenery,
construction activities without proper care, mis-use of natural resources,
etc.
Medical
Tourism: With a “Feel-good” environment creased
in India for the Healthcare Sector which attracting the businesses across, it
also attracting the patients from other countries. The main reasons are good branding with
trust, availability of medical experts, low cost involved in the process,
people-friendly environment in the country, and technology usage etc. Medical tourism is expected to generate
revenue of US$2.4 billion by 2012 [3].
Health
Insurance: The Indian Health Insurance market has
emerged as a new and lucrative growth avenue for both existing players as well
as new entrants. The Health
Insurance premium is expected to grow at a CAGR of over 25 percent for the
period spanning from 2009-10 to 2013-14 [6]. Governments are encouraging the
insurance players and so many schemes have come in the market. Governments have realized that it is
much better for them to offer healthcare insurance rather than healthcare
services through hospitals.
Governments have introduced several healthcare schemes to poor people so
that they will be getting the same corporate treatment for the diseases. The central government has established
Insurance Regulatory and Development Authority [IRDA] which is a statutory body
to for the regulation of whole industry [7].
Affordability of
Healthcare: The basic issue is now on the cost of
the Healthcare. We are able get the
required healthcare service from various players at par with a 5-star
hotel. Corporate hospitals have not
only raised the bar for healthcare in India, but also eased the pressure off
government hospitals dealing with tertiary care. Waiting time for the patients has come
down to almost zero in these private hospitals. The rise in costs is because of modern
technology. The checks before an
operation increase the safety in operation and it comes with some price. This ensures the quality in operations
and people are willing to pay more for such quality. Hospitals are maintaining the quality
standards like NABH / NABL in order to meet the competition [8].
Conclusion: Private sector
hospitals are also started to come with the concept of Corporate Social
Responsibility (CSR) by giving more subsidized rates so that the poor people can
afford for the necessary treatment.
IRDA should focus on (a) checking the costs of medical care, (b) develop
mechanism to check whether private insurance companies are providing same
facilities to all categories like rich, upper middle class, lower middle class,
and the poor by encouraging NGOs, and Cooperatives to enter into Insurance
business.
References:
[1]
www.Wikipedia.org
[2] Annual
Report 2008-09, Ministry of Health and Family Welfare, Govt. of
India
[3] Report by
India Brand Equity Foundation, July 2010 (http://www.ibef.org/)
[4] Emerging
Market Report-2007, Healthcare in India, Price Water House
Coopers
[5] Rupa
Chandra, Foreign Investments in Hospitals in India: Status and Implications,
IIM-Bangalore
[6] Booming
Healthcare Insurance in India, RNCOS, Apr. 2010
[7] Health
Insurance in India – Opportunities, Challenges and Concerns, IIM-Ahmedabad, Nov.
2000
[8] Innovating
around India’s healthcare Challenges, India [email protected], July
2010