The doyen of affordable healthcare in India Dr Devishetty moots an idea that Hospitals must be health insurance companies
Hyderabad, May 15, 2023……..Affordable healthcare is the right of every citizen. For health, you don’t have to have wealth. Wealth has nothing to do with the quality of the Health which our citizens can enjoy, said Padma Bhushan Dr Devi Shetty, Chairman, Narayana Hrudayalaya. He was talking virtually to a group of healthcare professionals assembled physically at a Round Table Meeting on “Vision 2030–Quality and Affordable Health for All in Telangana state”, organised by FTCCI in its boardroom at Red Hills, Hyderabad on Monday late evening.
Speaking further Dr Shetty added that we should prove that the poor can access health care. It is generally perceived that Healthcare is expensive and cost has to come down. As a Heart Surgeon when I returned to India 33 years ago, I did heart surgery on a patient in one of the hospitals in Kolkata at a cost of Rs 1.5 lakh. 33 years later, the same surgery is done at Rs 90,000/- under the government scheme. Now tell me where is it costly? If you reduce it further, the quality of the treatment will suffer, he said.
According to a survey, India needs 65 million surgeries every year. But today we are doing 26 million surgeries. What is happening to the balance of 39 million? he asked. They are either gradually suffering or have died from lack of access to the surgery. 70 to 80 per cent of these surgeries are simple ones. Even they are not accessible. That is not because of a lack of facilities or doctors, but because patients are unable to pay. The reason for that is the lack of financial intermediaries. That is a lack of health insurance.
Take for instance the missing middle class, who are 200 to 300 million in this country. They earn anywhere in the range of Rs 30 to 70,0000. A Rs 10,000/- health insurance annual premium they must afford to pay.
Speaking further Dr Shetty said, his group of hospitals, the Narayana Hrudayalaya, do 14% of heart surgeries done in India each year. If a poor patient is advised of a heart surgery that costs Rs 3 lakh, the only thing they can do is cry. They may at the most manage Rs one lakh. But that doesn’t solve the problem. Don’t blame the government. No government can do that. People like us have to do this, which means the people who pay taxes to the government are indirectly able to do so.
The countries that have managed “Universal Healthcare ” for free through taxation have three things in common. They are small countries with 10 to 20 to 40 million people. They are relatively very small countries with a good and high tax-to-GDP ratio of more than 30per percent and spend more than 10% of GDP on healthcare. And fortunately or unfortunately we are a large country with a tax-to-GDP ratio of 11%and spend 3.16% of our GDP on Healthcare. And the government’s contribution is 1.28%. If this is the situation, we can not expect the government to increase the budget allocation to healthcare. So what is the alternative? The only alternative is Health Insurance. The three key stakeholders in Health Insurance are hospitals, insurance companies and patients. Unfortunately, they don’t trust any. In such a situation, the scalability will not work. Patients today have to pay for the profitability of hospitals and insurance companies.
I have a suggestion, Dr Sheety said.. The suggestion is Hospitals must be Health Insurance Companies. This will change the rules of the game. If that is possible then there is no conflict of interest. No wrong advice is given to patients, he said.
He also suggested that 93% of the Indian workforce is in the unorganised sector. They must cultivate a culture of Health Savings Accounts and start depositing Rs 100/- a month. Health Saving Account(HSA) is a tax-advantaged account created for or by individuals. It helps individuals save on medical expenses. No tax should be levied on such savings. An HSA owned by an employee can be funded by both the employee and employer. There are so many states in India that are doing this. Telangana can also take a lead on this he said.
Responding to his talk. Anil Agarwal, President of FTTCI immediately said that FTCCI would start this for their employees.
Speaking further, giving his welcome address the FTCCI president said Dr Devi Sheety is a champion for quality and affordable healthcare in India.
The Guest of Honour B.R. Shamanna, Professor, School of Medical Sciences, University of Hyderabad said Telangana has a significant population of tribal origin and any policies made must be inclusive.
Shekhar Agarwal, Chairman of the Health Committee of FTCCI giving a theme address said if the god comes to this planet in the form of a human being, god sent Dr. Devi Shetty as a messiah for quality and affordable health. Speaking further he added that if the solution is not affordable, it is not the solution.
Mr Meela Jayadev, Senior VP of FTCCI, Ms. Khyati Naravane, CEO of FTCCI; Dr D. Dwarakanatha Reddy, Chairman of Vision 2030 Document-Quality and Affordable Health for All in Telangana and Indian Medical Association– Telangana, President, Rakhi Kankaria, Co-Chair of Health Committee and 50 other invited guests participated in the Round Table meeting. Dr Subodh Kandamuthan, Director of Administrative Staff College of India gave concluding remarks.