India is witnessing a transformation and there is an overwhelming necessity to provide universal healthcare, or full access, to the entire population as we go forward. However, the current brick and mortar model will not work as it is not possible to provide a hospital or clinic in every corner of the country.
We need to recognise human capital to deliver healthcare to our growing population. There need to be models which can leverage the multiplier effect. In today’s day and age the multiplier effect is digital. So the first thing to do moving forward is telemedicine. There are certain factors, including broadband, that are required for telemedicine to become effective and India is moving quite rapidly in that direction.
By 2035 the enabling technology will make it possible for us to actually monitor, treat and follow up with our patients remotely. Even today 50-60 per cent of the people who need treatment, don’t have to be touched as we have remote instrumentation available like ECG, BP, oxygenation, blood sugar etc. All this can be put online and a doctor who can see 30 patients a day today can actually see 100 patients then. The expertise takes a longer time to develop and there is an acute shortage of labour. For instance, why does anyone have to travel all the way to get a skin disease checked physically? Similarly, an eye problem can be monitored remotely. As the technology moves forward we could add on remote sensing devices. If the whole ecosystem moves in this direction, we could leverage the IT sector all across the country and 50-60 per cent of the patients may not even have to travel to access healthcare. They could get it right in their homes or at least in their neighbourhoods.
On the other hand, if we allow disease burden to continue the way it is, there is not enough money in the world to be able to treat every person who gets sick. Preventing the disease and decreasing the disease burden will help India achieve its 2035 healthcare goals. A huge amount of investment has to be made in wellness and health, rather than disease.
There are 60 million diabetic patients in India and another 70 million are pre-diabetic. Now should we allow the 70 million to become diabetic? There is a huge opportunity to change the course of the majority of that 70 million people. However, this will require a huge public health heft.
Today, we need to create awareness among people and leverage the power of IT and artificial intelligence. Artificial Intelligence is a reality and will continue to develop and be a major contributor to the healthcare sector. So if we concentrate on these things then we can hope to accomplish a lot which has not been done in the last decade.
The overall healthcare of the country at the moment is abysmal. If we do not take this as a wakeup call and reorient ourselves for the blueprint of 2035, it would continue to remain the same, no matter how much advancement the world makes in healthcare.
Everything needs to be planned. It is hard to make predictions as India’s healthcare is like a space mission. If you want to go to the moon in the next 20 years, then you need to start putting the bits and pieces in place today.
The government needs to roll out the blueprint where the total healthcare — government, private or NGO — has to be aligned with each other to deliver maximum benefit. Bringing down the disease burden will make it possible to be able to mitigate the lack of finances which is going to be a challenge for such a large population like India. You can’t say that we will have enough money and cite America’s example that even after spending over two trillion dollars, it still can’t deliver healthcare in the current model.
The basic thing is that we need to innovate and that is already happening in bits and pieces. Now, unless we develop that blueprint today and ensure that everything will move in the same direction, we will have chaos at the end of 20 years again or 2035 for that matter. The need of the hour is to have one single entity that becomes the health management agency of India which can actually make all this happen. At the moment we are moving in different directions with everyone looking after themselves but not playing any role in taking India to the next level.
We seem to be in a rush to copy the developed nations. Now in that rush, for instance, we have super speciality hospitals which may or may not be the right answer today for India, while the rest of the important needs have been left behind and ignored.
When we talk of the rural sector, there are two major components of primary healthcare — sanitation and basic civic facilities, and awareness. Once this is done, you would be able to deliver much more in future to those people. There is ample number of models in place; we need to string them together in one system.
There is overcrowding in the metros and that is unlikely to change in the future. Even if we carefully plan it as you do for any other industry, you can’t really hope that there will be a coordinated healthcare system as we don’t have enough nurses, technicians, IT, attendance technology etc. All this is at the moment very disconnected and we would not be able to deliver what we could by 2035.
Guest Author
The author is a renowned cardiovascular and cardiothoracic surgeon
