The Loot of Private Healthcare

The Loot of Private Healthcare

  • Health
  • by Devendra Gandhi & Binod Kumar Sinha
  • 16 Jul, 2020

Twenty-one year old Dhiraj spends sleepless nights trying to figure out how he can possibly pay back a loan of Rs 1.1 lakh and some interest to his family and a money lender. He had taken the loan for his mother, Bhuri Devi’s stomach ulcer operation that cost him Rs 1.50 lakh at a private hospital in Kanpur in March earlier this year.

To give a background, Dhiraj is from Shekhupur village in Uttar Pradesh’s Hamirpur district. He has a wife, a sister and parents to take care of. Two of his elder sisters have been married off. The children could not go to school because there were no resources back then. He migrated for work to Delhi three years ago where he started working in a hotel. He earned Rs 6000 a month, of which he sent Rs 2000 home. Initially his parents came with him but had to stop after Bhuri Devi fell ill.

In January this year, Bhuri Devi fell seriously ill. It began with a pain in the leg for which she went to some local doctor. There was relief for a few days and then the stomach pains began; she went to Sadguru Hospital (managed by a Trust) in Chitrakoot. There she was diagnosed with stomach ulcers; the doctors said she needed immediate attention within 24 hours or it could be life threatening. She was immediately taken to Kanpur and admitted to a private hospital—The Orient Hospital. By now the family had spent Rs 15000 on treatment and medicines.    

The Kanpur hospital displayed its Ayushman Bharat empanelment on a board and since Dhiraj was a golden card holder of the Ayushman Bharat Scheme, he decided to admit his mother there. The Scheme provides health coverage of Rs 5 lakh to golden card holders in an empanelled private hospital. It was only after admission that the hospital denied having any coverage under the Scheme. Within 10 days, they racked up a bill of Rs 1.50 lakh.

Data* shows that 7% Indians fall below poverty line due to healthcare spending and 23% of sick people cannot even afford healthcare. The numbers are staggering— 55 million people are pushed into poverty every year due to healthcare expenses and 38 million fall below poverty line due  to spendings on medicines alone.

They gave up all their life savings i.e. Rs 40,000. The remaining they loaned it from the married sisters and a money lender. Though she was treated for the ulcers, the pain in her leg has left her with a permanent limp. With the lockdown Dhiraj lost his work in Delhi and he has no work in the village. They do have job cards to get work under MGNREGA, it had remained inactive largely for the last 3 years and that made it difficult for them to get work. They did manage to get some work for a couple of days but the payment is stalled until a new card is issued. The ration under the Antyodaya Anna Yojana was not enough. They did not have the Jan Dhan Account, so they couldn’t get the Rs 500 promised by the government for a period of three months. And they could not avail the Pradhan Mantri Kisaan Samman Nidhi which provided Rs 6000 a year to cover some input costs because they did not own any land.

WHO’s health financing profile shows that in 2017, India’s 67.78% of total healthcare expenditure was out of pocket as against 18.2% globally. Club this with the above mentioned data and it screams the need for an efficient public healthcare system. The NCRB data reveals that between 2001 and 2015, nearly 3.8 lakh people died by suicide due to lack of proper, affordable treatment facility.

The measly expenditure of 1.28% on health is pushing people to private healthcare who are known to fleece patients. And it has been evident even more now during the pandemic. There are many like Dhiraj who are perhaps spending the nights tossing and turning, wondering how they are going to pay off that loan. And it is for this reason that there is an urgent need to increase the healthcare spending to 3% of the GDP.

The pandemic has shown that public health systems can deliver quality health services. More than 70% of our healthcare is privatised but it was the government hospitals that stepped in during this emergency. Perhaps with India being the chair of the executive body of the WHO it is a good time to increase spending on healthcare and ensure that no one loses a loved one because they did not have access to quality and affordable healthcare.

https://bmjopen.bmj.com/content/8/5/e018020.info

(Devendra Gandhi runs the Hamirpur-based Samarth Foundation)

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