Unfortunately, a lot of controversy and mistrust between the medical fraternity and the government has been generated by the introduction of the KPME act. We witnessed the unusual situation of thousands of doctors, health care workers and representatives of medical establishments taking to the streets (a very unusual situation in the medical fraternity) to request the government to reconsider the provisions of the act.
To cut a long story short, though all of us would like the common man and our patients to be treated well and get the benefits of modern healthcare, we believe that some of the provisions in the bill are unfair and draconian.
First and foremost introducing price control in the era of the free market economy will destroy the private health care industry which controls over 70% of tertiary health care for sure. It is important to point out that this 70% includes a large no of neighborhood small hospitals and mission hospitals which are in tier 2 and 3 cities and not just large corporate hospitals in the metros. If this act is enacted in the current form, we may have to go back to the olden days of control raj where for any serious ailment you had to go out of the state or country for treatment because no one would dare invest in the private hospital industry anymore.
Unfortunately, the private (PVT) sector had to fill in the vacuum created by very poor facilities in the public sector because of lack of funding (less than 2% of GDP for health care) poor infrastructure, inability to attract talent etc.
We feel it is unfair to only target the private sector when healthcare should be a fundamental right and the government should also be equally responsible if not more for providing this. The general impression that the public healthcare is free is a myth because it is the taxpayers who fund this and it is public money that is utilized against private investment in the private sector hospitals. Hence, whatever rules are made it should encompass both the sectors as mentioned in Justice Vikramjit Sen committee report constituted by the Govt.
Some of the provisions of imprisonment and hefty fines seem draconian. There are already many regulatory bodies like the medical councils, consumer courts and the judiciary to protect the citizens and adding one more layer will only lead to more confusion. Though it may be true that there are some rotten apples in the medical community like in other sections of the society, it is unjust to label the entire community as corrupt and dishonest.
In my opinion, since all of us have the common interest of providing the best of medical care to our fellow citizens, let us work together in coming out with reasonable fair solutions to these problems. It would be very unfortunate if we get into we (private ) vs them (govt.sector) in providing the fundamental right of health care for all.
What is the way forward?
The way forward would be to strengthen the public sector especially in rural semi-urban areas in the fields of preventive, primary and secondary care. Any government spending on preventive, primary health care saves a lot more lives than funding tertiary and quaternary care. Look at universal health care like the Medicare in the USA and NHS in the UK with a reasonable reimbursement for the care delivered after holding dialogues with experts and representatives from both the public and private sector The government should don more of a role of an insurer rather than provider of health care especially in tertiary and quaternary care.
Most of all let us not destroy the faith that the public have on doctors and health care facilities by insinuations that they are all rotten and need to be fixed.
Dr. H Sudarshan Ballal, MD, FRCP (London)Chairman – Manipal Hospitals
Manipal Hospitals, 98, HAL Airport Road, Bangalore-560017
Disclaimer: The views expressed in this article are of the writer and not of the hospital.