Reflections- E-newsletter for Clairvoyance 2011

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Equitable Healthcare: Reality Or Rhetoric?

By: Dr Arti Thapliyal, 

     MHA-Health (2010-12)

The hard push symbolic lines – “Go health “ , “ Health for all” , “ Healthy India” are good enough to give people a push to work hard towards improving health conditions at every level. But this fire-blowing assertive sound tends to mask the milder one’s saying “rampant malnutrition” , “ still high IMR”, “ Healthcare is unaffordable” and we realize that we systematically  tend to unhear this very crucial and critical sound which is no one’s but one of ours , our own country men,  our brothers and sisters.

In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures.

Voicing for healthcare is not the mere agenda here but the underlying purpose is to sensitize public and professionals for a longer term, get them thinking, touch their hearts and create realizations that there are many more “our people” whose healthcare needs have to be addressed.

Though with the advent of technology in healthcare, e-health, quality health, faster service, informed consumer etc, things have changed to certain extent, but only for a certain sect..! There have not been enough interventions for the major chuck of population which gets marginalized in every scheme, plan and policy.

Thinks are happening, happening for good and but not good enough…I would say not substantially enough. The soul and needs of the common man are not represented most of the time.

This discourse is very critical, especially on the lines of healthcare financing methods and making health affordable. Imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioral factors that affect the demand for appropriate health care are some of the new age challenges.

I am happy that Clairvoyance 2011 has decided to give voice to all these issues. This platform will be an opportunity for us to bring together distinguished healthcare professionals on a common stage and discuss these issues. As we expect, this might lead to new solutions / suggestions coming in and guiding our way forward.

With a note on anticipated success, I would just like to say – “everything is possible, we just need a dig with a Heart”.

Please visit http://clairvoyance2011.blogspot.com/ for more details on Clairvoyance 2011.

“Demand” Vs. “Need” in healthcare

by: Dr.Ajitendra, MHA-Health

Demand is an economic concept which describes the quantity of a good or service per unit time that an individual or household will purchase and consume at given price of goods or services. It is distinct from need which, in the context of health- can be seen as the level of health services which a medical specialist finds necessary to meet particular health indicator. When demand and need do not coincide the real problem surfaces.

When individuals demand for health services that medical specialist suggests they do not need, it causes waste of resources. On the other hand if individuals do not demand health services, which they medically require, it will lead to worsening of their health and if that disease is communicable, then of others too.

Concept of shortage: Both for Poor and Rich

“Rich: ever-growing demands not met”

“Poor: basic needs not met”

Apparently, market forces can’t provide the needed health care at affordable prices. Hence the government has to intervene to keep medical services within the reach of vulnerable poor and restore equity.

In rural areas, the need is very high, but demand or the purchasing parity is quite low, thus it results in lower supply. On the other hand stands the ultra modern urban city, where the demand has far more exceed the need and hence there is a continuous supply of medical care. The gap between urban and rural and the ‘haves’ and ‘have-nots’ is increasing as 75% of India’s health infrastructure & medical manpower are located in urban areas, where only 27% of population resides. Also largely preventable contagious and water borne diseases cause over twice number of death per year in rural areas than urban areas and immunization rates, pattern of delivery, IMR, MMR and other health indicator are skewed in rural areas.

This disparity clearly indicates the restructuring of workforce and other resources according to the need of people rather than demand. For better management and to achieve a more rational distribution of health care resources, one has to clearly distinguish between Demand and need and set the priority to meet 'Need' and tame 'Demand'.