Ayushman Bharat needs to live long
Farmers are not the only people who commit suicide in our country. If one family member is diagnosed with cancer, the whole family may be forced to kill itself owing to financial burden that the treatment cost of the disease brings. Owing to the lobby of private hospitals, government hospitals aren't offering any great promising service to patients of this disease.
Smallest of the small health concerns can be a cause of worry for middle class owing to the claims that private hospitals are ensuring treatment is never efficient and economical. Govt hospitals are being gobbled up by corporate hospitals.
BPL card holders have some dedicated facilities for themselves. But the mode class people are facing major challenges in a accessing your education and healthcare.
General hospitals of a country soena a lot about its focus and commitment of a govt towards its citizens. Healthy citizens are the future of any country.
Hence the budgetary allocation made by a government towards health gains significance. As per the World Bank, India had spent only 3.8% of its GDP on health care services in 2015. While the global average of spending on health care services stands at 9.9%, America spends 16.8% for this purpose.
Only 15% people in India are covered by health insurance and more than 94% of health expenses are met using personal financial resources.
Hence an unexpected health emergency can consume the whole family with its expenses.
Owing to all this, Modiji's Ayushman Bharat is deemed to be a significant step towards ensuring health for all. Through this insurance, every family will receive Rs 5 lakh worth health insurance to be equally distributed to 10 cr families in the country.
This scheme is said to be initiated ay different from Swasthya Bima Yojana that existed in the past. This would be introduced under AB-NHPM and this also includes upgrading of the existing primary health care centres to disburse better services and assistance. Insurance amount has been increased from Rs 30,000 in the past to RS 5 lakh now.
The government hopes to reach 40% of the country's population through this, while digitalising Rajiv Aarogyasri Health insurance on the lines of what exists in Andhra.
But there are already questions about the misuse of this scheme.
Though the scheme is wonderful, some aspects may turn into challenges and ruin its whole purpose.
About 40% cost of this scheme has to be met by state governments.
Since this adds financial burden on the states, they may seek financial aid from the centre to meet the expenses. Many states that are have glaring poverty may need more contribution from the central government. This will stretch them for resources.
This scheme may work well in urban areas, but rural sector will still suffer the lack of facilities because good hospitals are still a distant dream in villages.
About 75% hospitals and clinics, along with 80% of doctors exist only in urban areas. They are serving only 28% of the population. Hence there is immense scarcity of resources and expertise in other parts of the state. There is just one bed per 1000 persons at India while the developed nations have about 6.5%.
There are about 0.6% doctor per 1000 patient in India while developed nations have 3 doctors for the same number.
Only 37% people are entitled to avail health services as inpatients within 5 km radius of their living spaces and another 68% people can access healthcare services as outpatients in the same space. According to the World Bank, till 2015 over 15% of Indian children could not get vaccine for various reasons. Private hospitals are most certainly capable of using up every lacunae in govt hospitals for their own benefit. Lack of facilities provided by the government will force people to reach out to private hospitals which may exploit the insured person to fill its own coffers. Unnecessary procedures and surgeries may be performed for the sake of sucking money out of the system. This may push the patient to the brink of death. The family will be in penury over such expenses.
At the same time it is important to observe the behaviour of doctors in government hospitals as well. Running a private hospital is much more economically beneficial than working in a govt hospital alone. Hence it is an open secret that most doctors run private practice on the side. Since health insurance sector has private hospitals in its kitty, it would encourage most govt doctors to run a private hospital or a private practice on the sly.
This whole arrangement may facilitate people to depend more on private hospitals for even smallest of the ailments for which they'd never visit a doctor earlier. A monitoring system to manage all this is much needed.
One does not know whether the govt is aware of all these aspects and probabilities, and if there is a system in place to check them.
We must remember private hospitals are quite a gold mine for insurance companies. We need to focus on making govt hospitals better with facilities and service delivery. If govt hospitals can deliver better services compared to private hospitals at economical prices, the latter will naturally reduce their costing too.
Health services are better and popular among people when they are economical and of good quality. This is a simple truth. For instance private hospitals in Tamil Nadu are competing to overtake govt hospitals which are way better. This way private ones have to keep their prices low to attract the footfall of patients.
As against this, private hospitals in Uttar Pradesh have skyrocketing prices. Hence the govt needs to focus on preserving and making govt hospitals better than before in order to reach the benefits of its schemes such as Ayushman Bharat. Private hospitals need to be kept in check. Else they'd turn out to be the biggest threats to people's health.
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MP HC sets up judicial commission to probe water contamination in Indore
Indore (PTI): The Indore bench of Madhya Pradesh High Court on Tuesday set up a commission of inquiry comprising a former HC judge to probe the issue of water contamination in city's Bhagirathpura, saying the matter requires probe by an independent, credible authority and "urgent judicial scrutiny".
It also directed the commission to submit an interim report after four weeks from the date of commencement of proceedings.
A division bench of Justices Vijay Kumar Shukla and Alok Awasthi constituted the commission while hearing several public interest litigations (PILs) filed simultaneously regarding the deaths of several people in Bhagirathpura due to the consumption of contaminated water.
The HC reserved the order after hearing all the parties during the day, and released it late at night.
The state government on Tuesday told the HC that the deaths of 16 people in Indore's Bhagirathpura area was possibly linked to a month-long outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The government presented an audit report of 23 deaths from the current gastroenteritis epidemic in Bhagirathpura before the bench, suggesting that 16 of these fatalities may have been linked to the outbreak of vomiting and diarrhoea caused by contaminated drinking water.
The report, prepared by a committee of five experts from the city's Government Mahatma Gandhi Memorial Medical College, stated that the deaths of four people in Bhagirathpura were unrelated to the outbreak, while no conclusion could be reached regarding the cause of death of three other people in the area.
During the hearing, the high court sought to know from the state government the scientific basis behind its report.
The division bench also expressed surprise at the state government's use of the term "verbal autopsy" in relation to the report, sarcastically stating that it had heard the term for the first time.
The HC expressed concern over the Bhagirathpura case, stating that the situation was "alarming," and noted that cases of people falling ill due to contaminated drinking water have also been reported in Mhow, near Indore.
In its order, the HC said the serious issue concerning contamination of the drinking water supply in Bhagirathpura area allegedly resulted in widespread health hazards to residents, including children and elderly persons.
According to the petitioners and media reports, death toll is about 30 till today, but the report depicts only 16 without any basis or record, it said.
It is averred that sewage mixing, leakage in the pipeline, and failure of civic authorities to maintain potable water standards have led to the outbreak of water-borne diseases. Photographs, medical reports, and complaints submitted to the authorities prima facie indicate a matter requiring urgent judicial scrutiny, the HC said.
"Considering the gravity of the allegation and affecting the right to life under Article 21 of the Constitution of India and the need for an independent fact-finding exercise, the Court is of the opinion that the matter requires investigation by an independent, credible authority," it said.
"Accordingly, we appoint Justice Sushil Kumar Gupta, former judge of the Madhya Pradesh High Court, a one-man commission of inquiry into the issues relating to water contamination in Bhagirathpura, Indore, and its impact on other areas of the city," the HC added.
As per the order, the commission shall inquire into and submit a report on the cause of contamination -- whether the drinking water supplied to Bhagirathpura was contaminated; and the source and nature of contamination (sewage ingress, industrial discharge, pipeline damage etc).
The panel will also probe the number of actual deaths of affected residents on account of contaminated water; find out the nature of disease reported and adequacy of medical response and preventive measures; suggest immediate steps required to ensure safe drinking water as well as long-term infrastructural and monitoring reforms.
It will also identify and fix responsibility upon the officers and officials found prima facie responsible for the Bhagirathpura water contamination incident, and suggest guidelines for compensation to affected residents, particularly vulnerable sections.
The commission shall have powers of a civil court for the purpose of summoning officials and witnesses; calling up records from the government department, hospitals, laboratories and civic bodies; ordering water quality testing through accredited laboratories; conducting spot inspections.
All state authorities involving district administration, Indore Municipal Corporation, public health engineering department and Madhya Pradesh Pollution Control Board shall extend full co-operation and provide records as sought by the commission, it said.
The state government shall provide office space, staff, and logistical support to the commission, it said.
During the hearing in the day, the state government also presented a status report to the court in this matter.
According to reports, a total of 454 patients were admitted to local hospitals during the vomiting and diarrhea outbreak, of whom 441 have been discharged after treatment, and 11 are currently hospitalised.
According to officials, due to a leak in the municipal drinking water pipeline in Bhagirathpura, sewage from a toilet was also mixed in the water.
