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More than half of Indians can’t afford doctor: Govt Survey


Financial constraints force more than half of Indians to take treatment for ailments without medical advice.  The situation is worse in urban areas, where 68.3 per cent population could not afford to go to a doctor.  This was revealed in the latest round of survey on Health in India, by the National Sample Survey Organisation. The survey relates to the period January to June, 2014. The situation is still better in the rural segment, with only 57.4 per cent population taking treatment without medical advice.

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The next most important reason for not seeking medical advice is non-availability of any facility in the neighbourhood, with rural areas accounting for 15.4 per cent, while it is only 1.3 per cent in the urban areas.

Rural areas of Assam (84%), Odisha (76%), Rajasthan (44%) and Tamil Nadu (42%) and urban areas of Odisha (54%) followed by Assam (44%) and Kerala (31%) benefitted from public health facilities.

Table 1

The situation is accentuated by the fact that state-run healthcare facilities form less than one third (26 per cent) and the rest in the private sector, which is unaffordable for average Indians. This could be attributed to the stagnation in budgetary allocation of public funds to healthcare in successive years.

India’s public spending in healthcare is one of the lowest at 3.9% of the GDP (2011), while the economic burden of non-communicable diseases, NCDs, alone was 3.3% of the GDP (2004) or Rs. 84,600 crores (Rs. 846 billion). If NCDs were completely eliminated, the estimated GDP in a year would have been 4-10% higher, according to World Bank data.

Table 2

The Draft National Health Policy 2015 circulated by the federal Ministry of Health and Family Welfare says ‘The failure to attain minimum levels of public health expenditure remains the single most important constraint’ in achieving key goals.

According to a report by international voluntary body Oxfam, an estimated 35% of hospitalisations caused the respective families to be pushed into poverty. “In real terms, it meant health payments pushed 60 million people below the poverty line, per year. To put this into perspective, it is equivalent to the total population of the United Kingdom,” said the report.

Dr. Henk Bekedam, WHO’s Representative to India recently lamented, India has not taken healthcare seriously resulting in huge economic cost to treatment.  He said investment in healthcare means, investing for a healthy population, who could contribute to the economic development.

While national political parties have been claiming development as their key thrust area, healthcare has been given a short shrift. The Draft National Health Policy 2015 circulated by the federal Ministry of Health and Family Welfare says, ‘The failure to attain minimum levels of public health expenditure remains the single most important constraint’ in achieving key goals of development.

 The draft policy says, attainment of the highest possible level of good health and well-being, through a preventive and promotive health care orientation in all developmental policies, and universal access to good quality health care services without anyone having to face financial hardship as a consequence, is its goal.

India is also way behind in providing health expenditure protection to its population. Only 131 out of 1000 persons were covered under any state-funded insurance scheme, while 859 had no such benefit. Ten persons out of 1000 had other means expenditure protections. Telangana, Mizoram and Andhra Pradesh had the highest state-funded protection (729, 705 and 694 out of 1000 persons) followed by Chhattisgarh (397) and Kerala (388). Uttar Pradesh and the federally-administered enclaves of Andaman & Nicobar Islands and Lakshadweep had no protection of health expenditure, according to the Survey.

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