Govt must act to decommercialise health sector

I have got over the Covid-19 disease but not the shocks it created. Eight of our 10-member joint family had got afflicted from it. And our misfortune: the youngest of our brothers succumbed to the pandemic and the rest, like me, are safe. Achyuta Rao was dear, not only to all the family members and acquaintances but to many children, in the two Telugu speaking states, to protect whose rights he vowed to fight till his last breath and he kept his promise, no exaggeration! I am not detailing here on what he did as it falls outside the scope of this article.

Our instant fear, after testing positive, was not about Covid per se but about facing the dreaded disease in the background of our poor healthcare system.

Yes, our fears came true. When two of my brothers – including the one we lost – urgently needed hospitalisation, the actual trauma we experienced was much worse than what we had anticipated.

Admitting the Covid patients into a hospital is not an easy task; the situation is not like: you call an emergency number and an ambulance appears at your doorsteps in good time and you get into a hospital where the medics take your full care and treat you with empathy.

It needs a lot of effort to find a good hospital and enormous persuasion to get admitted into it; market forces principles of supply and demand strictly apply to health business and its profit maximisation approach becomes clearly visible when your need becomes compulsive like during Covid times.

Somehow, we could get both their admissions into two facilities of the same corporate hospital. But our ordeal did not end there. Things do not move fast enough, at the hospitals, to provide timely relief to the patients - procedures and financial matters take precedence over the patients’ health condition. We were asked to pay money in advance, before admitting and the beginning of every procedure and medication at the hospital.

The hospitalisation charges for seven days’ stay of my deceased brother was Rs 10 lakh. It would be higher by Rs 1,097.32 if the hospital were not generous enough to give that much discount in the end! The three days’ hospitalisation cost of the other brother was Rs 4.4 lakh! Given the state of our healthcare system, the hospital conditions could not be but hostile to the people.

Before commenting on our healthcare system, let me detail my battle with Corona. I did not go to any hospital because of the fear of rejection there, ‘no room for a corona patient’ and the fear of inhospitable treatment at the hospitals. Fortunately, my ailment level was also not so dreadful as requiring inevitable hospitalisation although my family doctor on and off suggested of its impending need.

It all began, during a midnight, with fever, chills and shaking, though for a brief spell. The temperature measured 102º F. The rapid test conducted next day shown me as Covid ‘positive’. The temperature continued unabated, peaked to 104.4º on the fifth day and settled at 103º for the next two days and turned normal from the eighth day. My sore throat which started mildly on Day-2, worsened and peaked on Day-3 when swallowing anything was a hell. But the pain started receding on Day 4 and totally disappeared on Day 5.

The medicines my doctor gave were: 1. Azithromycin 500, 2. Dolo-650, 3. Levocet-M; 4. Vitamin-C, 5. Zincovit, 6. Fluvir, 7. Fabiflu, and Vit D3 60K. When the temperature was at its highest, 104.4, on the fifth day, the doctor gave me a course of Dexamethasone 6 mg/day. The first dose of this medicine caused some nausea but fortunately subsided with eating a clove. This was followed by a five-day course of Methylprednisolone – starting with a daily dose of 40 mg and tapering it off to 8 mg on the fifth day. So, the medicines given can be classified to include, antiviral, antibiotic, antipyretic, antihistamine, steroids and some vitamins.

My diet included plenty of fruit, vegetables, curds and an egg a day and the other usual stuff. Consumed a lot of lemons, drank lukewarm water and regularly used steam inhalation during the first few days. Also, I kept ready with me a pulse oximeter and a thermometer to keep tracking my temperature and oxygen saturation levels. My oxygen saturation levels had been around 95 most of the time and never went below 90-92 making it compulsory to get admitted into a hospital.

These are only my experiences and I don’t recommend to anyone to exactly follow what I did because the symptoms and treatment choices need not be the same for every Covid affected. The best thing is to follow your doctor’s advice.

New policies no solace!

The nexus between corporate hospitals, pharma companies and doctors have increased the risks and costs of healthcare to such an extent that millions of middle-class Indians descend into poverty when they fall sick; every year, more than 3.5 crore people fall below the poverty line due to illness.

Unfortunately, the so-called health sector reforms do not address the root cause for the malady – commercialisation of the sector. The recently launched Pradhan Mantri Jan Arogya Yojana-Ayushman Bharat (PMJAY-Ayushman Bharat), too, cannot be a substitute for universal healthcare.

Similarly, the recently launched National Digital Health Mission and the National Health ID, which is going to be a repository of health-related information of the people, is unlikely to bring any positive changes in the healthcare system. If at all, the information will help the medical insurance companies to design their tariff policies and to reduce their risk, which means increasing the premium costs for users.

Hope the Covid wrought destruction and the resultant indignation of the people would now make the governments rethink and act to decommercialise the health sector. Bringing in a universal healthcare system free from commercial insurance interest is not the government’s magnanimity but it is its duty since the health protection is people’s fundamental right under Article 21 as held by the Supreme Court. So, to act quickly is the government’s duty and not to act amounts to its continued dereliction.

(The writer is a development economist and commentator on economic and social affairs)