JOIN USA study commissioned by the Karnataka Knowledge Commission on healthcare in the state has revealed the harsh impact that the government’s reduced investment on healthcare is having on people’s lives. The bulk of health expenditure in the state - around 66.8 per cent - is being borne by patients, not the government. This would not have been reason for concern if the patients concerned were rich. The problem is that the poor are having to shell out hefty sums for treatment. The study reveals that rural households are spending around Rs 7,918 per admission for treatment in private hospitals. The option of treatment in government hospitals provides only marginal relief at best. When patients seek treatment at government hospitals they pay around Rs 2,610 per admission. This payment is towards user fees and medicines. The ‘free’ treatment that the government boasts it is giving the poorest sections of society is clearly not free.
Medical care is the second most common cause of rural debt in India. Lacking the resources to meet medical costs, rural Indians turn to money lenders who loan them money at a high rate of interest. They are then sucked into a debt trap. Many stay away from treatment because they simply cannot afford it. Back in 1996, 25 per cent of rural Indians and 20 per cent of urban Indians were not availing treatment as they couldn’t afford it. That was in the early days of economic liberalisation. In the years since governments have cut down budget allocations on healthcare drastically. Those unable to afford treatment could well be double that in the mid-1990s. Higher allocation towards health and education will enable India to address several of its problems. Free medical treatment to the poor will improve maternal and child health, as well as the chances of survival of infants and children. With health improving, attendance in schools will rise increasing literacy.
Karnataka boasts of super-specialty hospitals that provide world-class health care. The state is at the forefront of the medical tourism business. While the government has bent over backwards to support the interests of privately-run hospitals, it has pulled back from providing even minimal health facilities for the poor. Clearly, its priorities are misplaced. It must increase budgetary allocation towards public health and make medicines available for free in its hospitals.