Health care crisis looming in India, Nobel laureate warns

Amartya Sen calls for greater allocation on health care and highlights ‘three general failures’ in the country’s health care segment

New Delhi: India spends just a little over one per cent of its GDP on health care and this is leading the country into “a comprehensive health care crisis”, according to Nobel laureate and noted economist Amartya Sen, who has called for greater allocation on health care in India and highlighted what he calls “three general failures” in the country’s health care segment.

“The fact that India allocates only a little over 1 per cent of its gross domestic product on public health care contrasts sharply, for example, with nearly three times as much by China. We reap as we sow, and cannot expect to get what other countries achieve by allocating much more resources — as a proportion of their respective levels of the gross national product — to health care,” Sen writes in his elaborate foreword to “Healers or Predators? Health care Corruption in India”, which will be launched here on Thursday.

Sen, a recipient of the Bharat Ratna in 1999, further claims that the entire organisation of Indian health care has become “deeply flawed”, leading the country into “a comprehensive health care crisis”.

“Despite being one of the fastest growing economies in the world, India ranks among the poorest achievers of good health. The shortfall of India’s health achievements compared with those of, say, China or Thailand is large and has been growing larger. Even within South Asia, Bangladesh and Nepal have overtaken India in health accomplishment, including in life expectancy.

“If India’s bad record in health care is not much discussed in the Indian press, this neglect does not indicate the presence of a tolerable level of health care in India, but reflects instead the narrow reach of the Indian news media, with its traditional neglect of elementary education and health care,” writes the 84-year-old economist.

Sen has extensively written on welfare economics and social justice and in the given book, he also highlights the plight of patients suffering at the hands of “private caregivers”.

He says private clinics “will not budge” without “the promise of payment”. Noting that even though some public services are offered freely, Sen highlights that many critically important services are denied unless the patient can cough up demanded sums, which can be “unaffordable” for many underprivileged Indians.

Taking a dig at the Medical Council of India (MCI), which aims to provide quality medical care to all Indians through promotion and maintenance of excellence in medical education, Sen blames the organisation for not only failing to perform its duties but also for its designated role of looking after medical colleges.

“In particular, in the use of the power — and responsibility — to set up new private medical colleges, there seems to be clear evidence of fairly straightforward corruption,” he claims.

He ends the over 1,500-word foreword to this “splendid, if depressing, book” with what he calls “three general failures” in India’s health care segment — “the amazing neglect of primary health care compared with health interventions needed at later stages”; “India’s hasty and premature reliance on private health care, which goes hand in hand with neglect of public health care”; and the deficiency of “informed public discussion on health care” in the country. Published by Oxford University Press, “Healers or Predators? Health care Corruption in India” has been edited by Samiran Nundy, Keshav Desiraju and Sanjay Nagral.

“This hard-hitting volume”, according to the publisher, “shows a mirror to the society and, more specifically, to those associated with the health sector — on how healers, in many cases, are shifting shape to becoming predators”.

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