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COVID -19 – A window of opportunity for healthcare

COVID -19 – A window of opportunity for healthcare

UPSC CSE Mains Syllabus: GS-2-   Issues relating to development and management of Social Sector/Services relating to Health,
Education, Human Resources.

COVID -19 – A window of opportunity for healthcare?

Private health care – accumulated ills:

  • Indian health care has been increasingly privatised over the last few decades. This has led to intense market competition.
  • uniquely unregulated form of health care has thrived.
  • It has also been marked by several questionable practices. Over-diagnosing and over-treating certain emergencies.
  • Cut practice’, with doctors and hospitals prescribing tests, drugs, referrals and procedures in return for commissions, is entrenched in India.
  • This leads to significant negative consequences, be it increased patient expenses, patients not reaching the right doctor or not getting the appropriate investigation, and also an erosion in the doctor-patient relationship and the image of the fraternity.
  • It puts ethical doctors in a quandary, making them cynical about their profession.
  • There are several grey areas in treatment decisions, where doctors are not sure of the best way forward for the patient.
  • For example, terminal patients with widespread cancers are often prescribed chemotherapy, which can cause side-effects worse than the disease, without impact on life span or quality of life.
  • These have been under the media and public glare leading to a huge trust deficit.
  • Will the changed milieu have an impact on this?

Some positive signs:

  • COVID-19 has led to a dramatic reduction in the numbers of patients seeking care.
  • This is especially true of planned, non-urgent problems including procedures and surgeries.
  • Many patients are scared to visit health facilities fearing COVID-19.
  • While this has caused collateral damage, there may indeed be those who have avoided interventions without any deleterious impact.
  • In other words, they have been spared of procedures for debatable indications.
  • For eg, the large number of women who undergo an unnecessary hysterectomy has reduced.
  • The incidence of Caesarean sections is reported to have gone down.
  • Similarly, procedures such as coronary stents, knee replacements or cosmetic surgery which reflect supplier-induced demand have almost stopped.
  • Routine’ admissions for ‘observation’ or ‘insurance claims’ have got curtailed.
  • However, during the pandemic, the availability of doctors, beds and proximity are now the chief drivers for patient referrals, rather than the commission route.
  • The focus has instead moved back to the basics of preventive health such as diet, exercise, good sugar control, and quitting smoking and tobacco.
  • The pandemic may have finally taught our population the importance of not coughing or spitting in the open.
  • These may indeed have more far-reaching benefits in a much larger population.
  • The COVID-19 epidemic has centre-staged the need for a robust public health system and increased investment.
  • While disrupting care, it may have unwittingly lead to some ‘desirable’ changes by the circumstantial curb on unwarranted medical practices.

Dangerous fallouts:

  • However, there are dangerous fallouts of the disruption as well.
  • The breakdown of overburdened health-care facilities, negative impact on the morale of health-care workers, and the collapse of private sector institutions (under financial strain) are all real.
  • With hospital and doctors incomes falling during the pandemic, there may be a resurgence of unethical practices as the industry tries to make up its losses.
  • This is already evident in the huge bills being slapped with, often by creating additional billing heads for COVID patients.
  • Though prices in the private sector have been capped, loopholes in the system may be found, such as profiteering on personal protective equipment.
  • Artificial demand maybe created in an effort to increase footfall.
  • Thus, the epidemic’s ‘positive’ impact on unnecessary practices may get washed away as ‘normalcy’ is restored.

Way forward:

  • In general, the medical fraternity in India has risen admirably to the challenge of COVID-19. .
  • It has forced them to consider alternative paradigms. Public respect for the profession has also improved.
  • If we can seize this chance to correct undesirable practices, it may help the return of trust in the doctor-patient relationship.
  • In the middle of gloom, this is a window of opportunity.

Source:”The Hindu”.

POSSIBLE UPSC CSE MAINS QUESTION:

An increase in Privatisation has brought many ills in Indian health care. Elaborate. Do you think the current pandemic is a window of opportunity to reshape the healthcare?