The document outlines key issues with India's healthcare system including a lack of infrastructure, shortage of hospitals and doctors, and low public spending. It then proposes several solutions like increasing public-private partnerships to build infrastructure, leveraging corporate social responsibility funds, and establishing District Health Associations to better coordinate healthcare delivery and expand insurance coverage. The goal is to improve access to care by addressing gaps in facilities, funding, awareness, and workforce across India.
2. Indicator India USA Brazil China
Hospital Bed Density(per 10000 population) 9 31 24 30
Doctor Density(per 10000 population) 6 27 17 14
Hospitals
Total expenditure on health as a percentage of
GDP
4.1 15.7 8.4 4.3
Govt. expenditure as a percentage of total
health expenditure
26.2 45.5 41.6 44.7
Private expenditure as a percentage of total
health expenditure
73.8 54.5 58.5 55.3
Health Insurance coverage as a percentage of
population
10 83.7 76.4 79.9
Present Healthcare Scenario
What the Statistics say??
India rates poorly on even the basic healthcare indicators when
benchmarked against not just the developed economies, but also against
the other BRIC nations.
3. Lack of Infrastructure
Huge Shortage of Hospitals
Dearth of Hospital Beds
Lack of Ambulances
Shortage of Manpower
Shortfall of Primary Doctors,
High No. of Vacancies in positions of Health Workers and Nurses
Lack of Government Funds and Private Investment
Public Sector accounts for merely 26% of total healthcare
expenditure
Public Health Spending merely 1% of GDP
Lack of Awareness
Insurance
Lack of information about government healthcare schemes and
policies
4. Infrastructure :
Need to encourage Public-Private Partnership in this sector for
improving infrastructure as government spending on health is
extremely low.
CSR can be a game-changer : Every company with certain level of
business has to invest 2% of its profits for CSR. 20% of this CSR fund
should be made mandatory to finance a hospital-cum-medical
college in a designated government area. This medical institution will
be maintained by the DHA, as per MCI norms. These institutions will
run with the primary motive to improve primary healthcare facilities
and provide free medical education.
There is a need to increase coordination between the government,
administration, private sector and NGO’s. For this, one District Healthcare
Association(DHA) should be set up which comprises of the above
mentioned parties.
5. District Health Centres (DHC)will be set-up under the supervision of
the DHA. The motive of these DHCs is to monitor all healthcare
missions being carried out in the district. Under these centres, the
following functions will be carried out:
24X7 Toll-Free Helpline : Helpline number will be set-up
connecting every village directly to the DHC.
Medicine Shops to be set-up in every gram panchayat supervised by
the DHC, to distribute free/generic medicines.
One Village, One Ambulance : Mandatory for every Gram
Panchayat(around 5k population) to maintain one ambulance,
which will be available through the helpline number of DHC.
Telemedicine : There is a need to set-up one 24x7call center,
maintained by Indian IT companies, which will provide emergency
guidance for patients in remote areas.
Grievance Redressal Mechanism : Registration of complaints
regarding the healthcare system through the 24x7 toll-free helpline.
6. Manpower :
Huge shortage of primary healthcare doctors, out of which 74% work in
urban areas, which account for only 28% of the population.
Need to raise the standard of medical education and simultaneously
decrease the expenditure on medical education and complexity of
the entrance process to medical colleges and introduce Personal
Interviews in the selection process.
More primary healthcare doctors required,rather than the highly-
specialised doctors. Government spends Rs. 1.5cr per doctor coming
out of AIIMS, while it spends only Rs. 25 Lacs on a normal MBBS. In
the last 30 years, 53% of AIIMS passouts are now practicing abroad.
Category Current Required
Physicians 757377 1200000
Dental Surgeons 93332 300000
8. Funds :
Public sector plays a small role in healthcare financing. Hence, the private
sector has a pivotal role in financing the healthcare expenditure in India, with
out-of-pocket expenditure accounting for a disproportionate 90 percent
funding of the private expenditure on health.
Therefore, health insurance has a critical role in improving access to healthcare
services in India Increasing penetration of medical insurance would also result
in an increased demand for quality healthcare services. The coverage of health
insurance in India is merely around 10 percent of the total population.
Solutions :
Health Insurance Scheme : A National level health insurance policy to
provide free health insurance coverage to all people below poverty line, and to
link it with Aadhar Card.
The primary motive is to bring health insurance at an equal pedestal with
life insurance.
This scheme will be supervised and carried out by Life Insurance
Corporation(LIC) of India.
Private Hospital Contribution : DHA will forward some BPL cases to
nearby private hospitals and it is the responsibility of private hospitals to
contribute 5% of its profits to provide free health facilities in such cases.
9. Awareness :
Urgent need to create widespread awareness about the necessities and
importance of primary healthcare.
Publicity of government policies is not undertaken aggresively, as mostly the
advertisements are broadcast on only Doordarshan or some news channels.
Solutions :
Better Advertising : Advertisements of government policies will be
outsourced to private media houses and ad agencies, and counted as a CSR for
these private firms.
Private Channels will be asked to telecast government policy
advertisements free of cost, again, as a part of their CSR.
Subsidy for NGOs : NGOs working in the healthcare sector, will be
provided subsidies to promote primary healthcare through street plays, health
camps, etc.
10. Overall Ex-officio Chairman : District Collector
Supervisory Committee consists of 10 members –
Chief Medical Officer, 2 members from a prominent
local NGO, 3 prominent doctors, 2 representatives of
the companies spending their CSR fund in the district,
1 health activist, 1 social activist.
11. District Health
Association(DHA)
District Health Centre
Swasthya Sanrakshak Yojana
24x7 Helpline
One Village, One Ambulance
Tele-medicine
Grievance Redressal
Mechanism
Ayushmaan
Public-Private
Partnership
Using CSR for hospital-cum-
medical colleges
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