Bed no. 13. Vikram. The patient had a blank stare as if he had given up all hopes. As I approached him for the routine history taking, his mother was all too eager to have someone to share her grievances with. Vikram was a farmer and while doing some physical work had injured his back. That’s when his life started going downhill. He ignored the pain initially as it went away with the pain killers. But one day it became too severe to ignore, he couldn’t move, much less work. He couldn’t avoid going to the hospital anymore. But this wasn’t an easy thing for him. He was the sole earner of his family, missing even a day of work would mean no food for the day. “It is day 20 now that he hasn’t worked. The cost of surgery is too much and I don’t know how I will arrange it. But everyday we are here means my other kids are hungry back home. I have to watch my son suffer daily and watch helplessly as I can do nothing for him. I don’t know why God is testing us!” sobbed the poor old woman.
We can easily replace Vikramwith an accident victim in a village with no hospital not reaching the city on time, or someone requiring urgent surgery but not getting it on time because they couldn’t afford it and the list could go on. The Indian constitution lists healthcare as a fundamental right under article 21, but the paradox is that the current healthcare scenario is anything but this. With a major population rural and below the poverty line, most people rely on the public sector to achieve their healthcare needs. According to estimates, 90% of the healthcare needs can be met by the primary healthcare centres but India has only one PHC per 51,000 people which is usually manned by a single doctor. The worst fact about this is that most remote areas, even if they do have a healthcare facility, it lacks the necessary equipment and infrastructure to provide quality care and consists of disinterested forcefully sent interns who work as a part of their curricular requirements. So a majority of healthcare burden goes to the private sector with sky rocketing costs, as is evident from the fact that India has one of the highest rates of out-of-the-pocket costs. Health insurance also is not owned by a majority of the public.
So, imagine if you’re a daily wage worker or live below the poverty line and meet with a sudden accident, your treatment and recovery might cost you your entire life’s earnings. It basically means that India’s poor cannot “afford” to get sick! But getting sick isn’t in our control, is it?
An India of my dreams will be the one with universal health coverage. What this means is that every individual should have an access to quality healthcare irrespective of their socioeconomic status. We are at a stage where advanced medical technologies and innovation are capable of curing illnesses that once used to be deadly. But if people in our country are dying of conditions which can very easily be cured if given proper care in the right time, it indicates that our healthcare system needs a radical change. The healthcare should also not come at a cost which will render the individual financially handicapped. India of my dreams will be a place where someone’s cause of despair is not an ailment they had no control over. India of my dreams will be the one where living in a village is not synonymous with poor, inadequate facilities. India of my dreams will be the one where hospitals are not seen by people as evil money draining buildings and doctors are not seen as looters, but rather a place people go to seek comfort, wellness and relief from their problems and doctors, whom they will trust with their lives, as a means of achieving this. With the recently introduced schemes such as Pradhan mantrijanaarogyayojna and Ayushman Bharat national health protection mission, achieving this is a possibility in the near future. India of my dreams 2020 will hence be an India where healthcare is actually a fundamental right.