Affordable Care Should Be Our Motto

Dr Sanjeev Singh , Medical Superintendent , Amrita Institute of Medical Sciences

"We are very proud of the public sector which has taken care of masses at a reasonable price, but contribution toward publication, research, patents, and innovation should be brought to the drawing board. "

Healthcare industry is growing at a tremendous pace owing to its strengthening coverage, services, and increasing expenditure by public as well private players.

On the healthcare market

The Indian healthcare sector is growing at a brisk pace due to its strengthening coverage, services, and increasing expenditure by public as well private players. Indian healthcare delivery system is categorized into two major components – public and private. The government, that is, the public healthcare system comprises limited secondary and tertiary care institutions in key cities and focuses on providing basic healthcare facilities in the form of primary healthcare centers (PHCs) in rural areas. The private sector provides majority of secondary, tertiary, and quaternary care institutions with a major concentration in metros, tier-I, and tier-II cities. India's competitive advantage lies in its large pool of well-trained medical professionals. India is also cost competitive compared to its peers in Asia and Western countries. The cost of surgery in India is about one-tenth of that in the United States or Western Europe.

On vision for health and family welfare

Healthcare industry in India is a collective of many sectors. It is considered one of the largest sectors that offer health and medical services to an extensive population. The idea of proper well-equipped medical facilities, interactive medical aid program, etc. has certainly helped in the boom of healthcare industry.

Another major contributing factor is the healthcare IT sector. Many digital health processes in India have immensely helped to spread healthcare awareness. There have to be many supportive factors for using reliable healthcare apps such as: online appointment scheduling and cancellation; easier way to review test results and download them; and one can quickly upload medical records and keep it saved in a folder. This gives accessibility to view reports from anywhere.

The future of healthcare in India is bright and people will be more and more curious about knowing what the healthcare sector has to offer. India being one of the most highly populated countries in the world offers a lot of scope for a sector like healthcare to boom further.

On expansion plans

Our expansion plan is to bring visibility to pediatrics and its subspecialties. All adult medicine subspecialties have grown and they are recognized as a separate independent division. The same has to happen for pediatric patients, so that each patient gets specialized care.

We are also looking at High-Precision Care with high-end biomedical equipment with affordable cost. This will include high-precision radiation oncology viz cyber knife and tomotherapy, robotics in each surgical specialty, especially in unexplored chartered divisions like pediatric surgery, head and neck oncology, thoracic surgery, and the like.

We are looking at building a high-end state-of-the-art center. This would include a medical and surgical simulation center. This will also include robotic wet and dry lab training for any robotic procedures.

We are looking at digital diagnostics and high-precision correlation, turnaround time, and accuracy.

On planned budgetary allocation for the fiscal year 2017–2018

Medical equipment and devices allocation is done on a case-to-case basis and is as per a financially sustainable plan. The intent is to offer high-end services at almost the same cost as conventional procedures, so that patients get benefitted, the most.

On challenges faced while implementing health services

The Department of Family Welfare is responsible for aspects relating to family welfare, especially in reproductive health, maternal health, pediatrics, information, education and communications; cooperation with NGOs and international aid groups; and rural health services.

Challenges in implementing health and family welfareprograms include a big gap between public and private sector understanding. Public private partnership is all talk but less action. Skilled manpower is not available to be able to deliver HFW programs. Data and its analysis for better outcome are lacking. Government is looking at bigger roll out programs with intent of universal health coverage, but process improvement for better patient outcome is not in their agenda.

On areas requiring government investment

The healthcare sector is made up of many different industries – from pharmaceuticals and devices to health insurers and hospitals – and each has different dynamics. Investments in this sector are affected by many variables, including positive trends related to demographics and negative trends related to reimbursement.

Government should consider investing in the private sector since 70 percent of healthcare is delivered from the private sector. The private sector contributes to 4 percent GDP toward healthcare delivery. Instead of creating parallel competition, some portion of healthcare should be sublet to the private sector at an agreeable cost for the benefit of the poor.

Government should invest on digitization and skill development. Government is building and also has a plan to compete with private sector, but until competency is developed and skill mix is encouraged, the intent gets lost leading to a downhill trend.

Positive trends where government should invest in programs include: the aging population; people living longer with chronic disease; obesity and diabetes epidemics; technological advances; the global reach of disease; and personalized medicine.

On the accusation of meddling with pricing policy

Government is on track to control healthcare, which is good and bad. It is good, because a large section of government and public feels that the private sector does not deliver on quality but is fleecing money. Hence the value derived from the private sector is not proportional. It is a bad trend, since adequate input/exercise regarding costing a procedure is not being undertaken. All stakeholders are not involved in the process of costing. If there is an exorbitant margin between procurement and selling cost, then that has to be curbed, but justified costing and pricing should be done.

The private sector also needs to practice ethically and should bring in transparency in costing and pricing for greater good.

On challenges

The recent move to allow 100 percent FDI in medical devices outsourcing by the Government of India will change the outlook of the industry for the better. In the past, the absence of a clear and consistent regulatory framework and lack of adequate incentives and funding for manufacturing devices in India has kept the industry from realizing its full potential. Although the changes in FDI policy will help to improve the sector, there are a number of other challenges that could deter foreign investors from manufacturing in India. High tax rates imposed on domestic manufacturers have made investment unappealing to some foreign companies, given the comparatively low amount of tax levied on imported medical goods. It is therefore hardly surprising that foreign firms often choose to access India's medical market without establishing a direct presence; many companies establish factories in neighboring countries and export devices into India.

On opportunities

Despite the current challenges compared to the global market, some of the advantages India will continue to offer in areas like reduced cost of labor, a high level of technical expertise, and funding from governments for R&D investment to accelerate new product development has made India one of the most favored destinations for outsourcing manufacturing services. With more and more multinational firms looking at customizing their products to suit country-specific requirements, the segment is only likely to grow in the coming years. The recently tabled The Drugs and Cosmetics Amendment Bill, 2013 is expected to recognize the uniqueness of medical devices, equipment, consumables, and diagnostic products. With this disengagement of medical devices from drugs, there will be significant reduction in timelines for approvals or licenses for medical devices. This will help local manufacturers to grow significantly and compete on a global scale.

As stated by a new market research report on medical device outsourcing, the United States represents the largest market worldwide. Asia-Pacific is forecast to record the fastest CAGR of 14.9 percent over the next four years. Less expensive production of devices coupled with adherence to stringent international quality standards marks the emergence of Asia as the most desirable production hub. Asian countries, specifically India and China, are emerging as attractive low-cost destinations for leading medical devices OEMs.

All stakeholders need to be brought together, engage appropriately, and providing quality healthcare at an affordable care should be their motto. With a common goal and understanding a partnership model between the public and private should be devised for the betterment of healthcare. We are very proud of the public sector which has taken care of masses at manageable price, but contribution toward publication, research, patents, and innovation should be brought to the drawing board. Let us work together and offer best services to patients.

  • Author :

    Dr Sanjeev Singh , Medical Superintendent , Amrita Institute of Medical Sciences

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