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Monday, August 24, 2015

Impact of red tape on the healthcare in India

India is a great nation of over 1.2 billion people. It stands on a 11,000 year old strong culture that is probably matched only by the Mesopotamian culture. It has survived many invaders such as the Arabs and Europeans. After its independence in 1947, India was faced with many problems - poverty, poor healthcare, illiteracy, population explosion, security threats from neighboring countries, to name a few. Since 1980s, economic reforms have propelled India into a an era of rapid growth and development such that the GDP growth during January–March period of 2015 was at 7.5% compared to China's 7%, making it the fastest growing economy. Despite these developments, healthcare sector lagged behind in responding to the healthcare needs of the  nation. 

In a recent article in the New England Journal of Medicine, Dr. KS Reddy states "With weak regulatory systems failing to set and enforce quality and cost standards, some patients receive inadequate, inappropriate, or unethical care. 70% of health care expenditures consist of out-of-pocket spending". Today, the private sector accounts for about 80% of outpatient and 60% of inpatient care. The reasons behind this appalling state of affairs are many. Red tape and corruption are among the top causes leading to the current state of affairs. to state an example, the Supreme Court held the government and the Medical Council of India (MCI) guilty for the loss of 3,920 MBBS seats mainly because of lethargic inspection of infrastructure in medical colleges and non-grant of timely permission to colleges to admit students! Red tape swallows all walks of life from education to filling job vacancies to providing healthcare to the people. 

Failure on the part of any hospital to provide timely medical treatment to a person in need of such treatment results in a violation of the patient's "Right to Life,which is guaranteed under Article 21 of the Constitution of India. This is the closest India has come to enacting laws similar to The EMTALA (Emergency Medical Treatment and Labor Act) and the COBRA (Consolidated Omnibus Budget Reconciliation Act), which are well recognized in the United States. In 1988, the Honorable Supreme Court of India had stated that every injured person be administered emergency medical care to preserve life and there should be no legal impediment to providing medical care. It is shameful to note that there has been no law to this effect and we, Indians, continue to not care for those in need of emergency medical aid.

How can we change the way we treat our people? Should there be a law enforcing people to care for fellow citizens? Should we punish people who see a person dying but, don't come forward to assist him/her? Should we enforce all the hospitals to provide emergency care? Unfortunately, the problem lies in the mindset of the people more than anything else. How can we get people to care for their fellow citizens? I do not know the answer to this question. But, one thing is sure, IF WE, THE PEOPLE, DO NOT CARE FOR OUR FELLOW CITIZENS, NO ONE ELSE WILL

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