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Is it time to rethink healthcare? With COVID-19 disrupting processes, economies and human behaviour we must notice that our knee-jerk reaction to this pandemic isn’t going to take us far. What is even more crucial is to ponder upon how we give far more importance to defence budgetary allocations than the allocation towards health care. And, this is not limited to India. We believe that COVID-19 has brought to us an opportunity to bridge the funding gap in public healthcare and in the area of research and development that lies at the foundation of new health-tech developments.
One percent of India’s GDP, $595,512 million in the last quarter of 2019, makes up its health budget, catering to almost 1.3 billion people. When put in the context of India’s other budgets, it is simply not enough to cover the population. For the Indian middle-class public healthcare is simply not an option and as for the lower-income groups, lack of trust in public hospitals makes it their last resort. They are more willing to take out loans and burden themselves, as opposed to approaching public hospitals. As per WHO, India ranks 184th out of 191 in terms of GDP expenditure on healthcare.
Given this, the patient to bed ratio in government facilities is at 0.55 beds for every 1000 people. Dilapidated infrastructure, a high influx of patients, and scarce human resources, there is one doctor in government hospitals for every 10,000 people. Moreover, the lack of political will and/or vision has made technological upgrade snail-paced, and thereby obsolete when it is introduced. Even smaller, private clinics offer higher salaries, better working conditions along with added perks, which leave less incentive for doctors to join public hospitals. This has rendered the public health system in India, limp.
Now, let us try introducing another variable to this already flawed complex space — COVID-19. This pandemic has exposed the weaknesses of the Indian public healthcare system. It is not wrong to say that before COVID-19, our public healthcare system was in the I.C.U. and now it is on a ‘ventilator’.
The solution is not to simply increase the budget, and splurge money, anymore, the focus now has to shift on optimum utilization of this budget in a manner that tackles basic issues and introduces — public insurance, upgrading infrastructure and technology, and increasing the number of healthcare workers manifold. Government(s) must realign their priorities, and not draft manifestos and policies that are short-sighted serving the purpose from one election to another, they must focus on continued sustainable and tech-driven plans.
Given the conundrum we are all in, innovations in health-tech are going to define the post-COVID normal. We believe India’s public health budgets will need to factor into account digitization of healthcare assets and healthcare players — both public and private — will need to strategically integrate AI in their service ecosystems.
This shift towards making technology-enabled healthcare the backbone of a healthcare system will help India, as a nation, pivot towards medical distancing, reduce the turn-around-time of diagnosis as data will be crowdsourced across the supply-chain, will ensure that real-time diagnosis data can be utilized for efficient insurance claim settlement, and will ensure that the cost per healthcare services at every stage can be standardized.
These shifts will help India break from the referral model that the industry currently heavily relies upon and will make pricing in this industry far more transparent than it currently is. However, the blind spot in moving forward with this strategy is that citizens’ online data will need to have similar rights as citizens do.
Ergo, we believe, digital intervention in healthcare, sustained use of AI and ML in the healthcare ecosystem and corresponding investments in insurgent health-tech players, will be India’s Healthcare systems’ mezzanine financing round at a time when it's bleeding heavily. Renowned Consultant, General Surgery, Vinayak Mane says, “While health-teach is the need of the hour, our healthcare workers are not adequately equipped to handle and/or acquainted with technology as such. A strong push for health-tech needs to also usher an equally strong attention to skill development. Expenditure on man and machine must be at par, in this situation.”