Syllabus
GS Paper 2 – Social Sector: Issues relating to development and management of Social Sector/Services relating to Health, Education, Human Resources.
Context
Access, innovation, and affordability need to be kept in mind while shaping equitable and sustainable health-care policies.
Source
The Hindu | Editorial dated 4th June 2024
The delicate balancing of health-care costs
With rising health disparities and uneven access to medical services, the need for equitable and sustainable healthcare policies has never been more urgent. Discussions on setting rates for medical services fundamentally shape how we perceive, access, and deliver healthcare across India.
The Supreme Court of India, while hearing a Public Interest Litigation (PIL) in February, 2024, directed the central government to find ways to regulate the rates of hospital procedures in the private sector.
Private Healthcare costs in India
The Court highlighted the problem using the procedure costs of cataract surgeries that cost only around Rs. 10,000 in a government set-up and between Rs. 30,000 to Rs. 1,40,000 in private hospitals.
The Supreme Court’s consideration of standardizing medical procedure rates aims to make healthcare more affordable. However, there is a risk that uniform price caps could compromise the quality of care.
Significance of private healthcare
- Specialized Care and Innovation:
- Private hospitals, particularly those accredited by Joint Commission International (JCI) and the National Accreditation Board for Hospitals (NABH), focus on providing specialized medical services and fostering innovation in health care.
- Centers of Excellence:
- These hospitals often attract top medical talent and invest in state-of-the-art facilities and equipment, making them leaders in advanced medical procedures and research.
- Investment in Technology:
- Private hospitals invest significantly in cutting-edge technologies such as robotic surgery, advanced imaging systems, and minimally invasive surgical techniques.
- Enhancing Patient Outcomes:
- These technological advancements lead to better diagnosis, more effective treatments, and improved overall patient outcomes, particularly in complex medical cases.
Impact of Price Caps
- Potential Drawbacks:
- Imposing a one-size-fits-all approach to pricing may not account for the variability in costs associated with different levels of care and complexity of procedures.
- Financial Pressure:
- A Health Care Management Review study indicates that hospitals facing financial constraints due to price caps experience a 15% increase in patient dissatisfaction.
- Slowed Innovation:
- Price caps could reduce the funds available for research and development, slowing the progress of new treatments and technologies, particularly in critical areas like cancer research and robotic surgery
Ensuring balance between care and cost
- Dynamic Pricing Models :
- Dynamic pricing models take into account the complexity of medical procedures and the financial status of patients, offering a more tailored and fair pricing structure.
- These models help ensure that patients receive necessary care without imposing undue financial strain on healthcare providers.
- Legislative Reform
- Managing healthcare costs effectively requires legislative reforms that accommodate local demographic and economic conditions.
- Robust legal frameworks can support rate standardization efforts while ensuring high-quality care.
- State-level initiatives can help address specific regional challenges and ensure that pricing policies are effective and fair.
- Managing healthcare costs effectively requires legislative reforms that accommodate local demographic and economic conditions.
Case Study – Thailand
Thailand’s Tiered Pricing System: Thailand successfully balances cost and care by considering patient-income levels and medical necessity in its pricing system.
This system could serve as a model for India, addressing its diverse economic landscape and varying healthcare needs.
Conclusion
Balancing access, innovation, and affordability in healthcare is both delicate and imperative. Implementing pilot projects to gauge the impact of rate caps, allocating subsidies for research, and establishing public-private partnerships can ensure widespread access to advanced healthcare solutions. As India aspires to be a global healthcare leader, fostering an environment conducive to innovation while ensuring equitable access to quality care is crucial.
Related Topic
eSanjeevani
- It is a cloud-based integrated telemedicine solution of the Ministry of Health and Family Welfare, Govt. of India.
- It is a telemedicine app that provides both doctor-to-doctor and doctor-to-patient telecommunication.
- It is being designed, developed, deployed, and maintained by The Centre for Development and Advanced Computing (C-DAC), Mohali.
- Two modules of eSanjeevani:
- eSanjeevani AB-HWC:
- The doctor-to-doctor telemedicine platform, being implemented at all the Health and Wellness Centres (HWCs) in the country under the Ayushman Bharat (AB) Scheme of Government of India.
- It operates on a Hub-and-Spoke model wherein the ‘Ayushman Bharat-Health and Wellness Centers’ (HWCs) are set up at the state level, which is connected with the hub (comprising MBBS/ Specialty/Super-Specialty doctors) at the zonal level.
- It was rolled out in 2019.
- eSanjeevani OPD:
- It is the Patient-to-Doctor remote consultation services rolled out in 2020 amid the first lockdown imposed to fight the Covid-19 pandemic, while the Outpatient Departments (OPDs) in the country were closed.
- eSanjeevani AB-HWC:
References
Related PYQ
Appropriate local community-level healthcare intervention is a prerequisite to achieve ‘Health for All ‘ in India. Explain. [ UPSC Civil Services Exam – Mains 2018]
Practice Question
Examine the implications of setting standard rates for medical procedures in India on healthcare quality, affordability, and innovation. [150 words]