AN OLIGOARCHY FABRICATING HEIRARCHY: SOCIOPOLITICAL INDIAN HEALTHCARE SYSTEM
JR, General Surgery
I finish my rounds in record time, my heart rate speeding a gallon, before I haul my tired self to the OPD. Ten hours of gruelling OPD in a very short staffed government setup can make you ignite frustration at innocuous things, but you train yourself to hold it all in and gulp it down like an ice bucket challenge.
And today is no different. Interestingly, I encounter the following characters, so starkly vivid, it leaves an impression in my mind.
- In walks, Mr. I-am-the-son-in-law-of-the-regional-slightly-famous-MLA, fancy rings on his hand, snug deep in his trousers, attitude shooting from the invisible plane his nose makes with the sky, voice as gruff as a lion’s roar, and impatience triggering faster than a second. He has a big bunch of people following him. He zeroes in on me, ready to corner me if I don’t give him the attention he needs. He gives me the specs of his stratus easily, demands my attention despite skipping line and wants ‘his’ patient admitted in the ‘special ward’ immediately. The actual patient follows closely behind the bunch, timid, frail, with no idea why he was brought here, except that he has an inguinal hernia.
- In walks, Mrs. I-am-all-alone-with-no-one-to-care-for-me, bland face, bland looks, and a baggage full of broken dreams. Breast cancer. Husband gone. Lonely washes her talk, lonely is the substance that fills her ballads. Knows she needs treatment, understands the course of the chemo and radiotherapy, but due to her stratus, long gone safe deposits, she can’t even try. Just plain follow up, tears clouding her eyes, no wish, no hope, just acceptance.
- In walks, Mr. I-work-in-the-labor-industry-with-a-manageable-income-to-barely-support-my-family, pants hanging loose off his body, shirt worn so many times, it’s the color of his teeth, logic brimming his talk. All he wants is less hospital stay time. All he cares about is his BPL card, and how that will ensure he gets free treatment for his hemorrhoids.
- In walks Mr.I-have-been-abroad-I-have-tasted-the-salt-in-the-foreign-countries-and-know-enough-English-to-converse-better-than-you, a forcible accent to his talk, a forcible attempt to look sophisticated. He knows he can go to a fancier hospital, a fancier tertiary care with oodles of swag, but somehow he chooses a place inferior to his expected stratus. Not sure of his agenda, but surely having read up about everything he can from dear Mr.Google, his persona reeks ‘show-off’. He questions your judgement, questions your management and creates havoc with every choice you make.
Make no mistake, the above are all flavours of this wonderful country. Flavours that sting, bite, satiate and burn. Flavours you want to roll through, hang onto, crush and even throw out. For doctors, these flavours are not stratifiable – our patients are all like our children, we don’t get to even diplomatically choose one over the other, akin to a mother and her children. Health card or no card, money or no money, health is health, and health is what we swear by; the Hippocratic Oath a brandishing on our every action.
Despite what the government does and says, despite the various policies in play, despite the various support groups, one must understand the role that politics plays in the Indian scenario. Hoping for a transparent, wide slate of see through economy and bank balance will never exist and it’s rudimentary to hope for such a situation. Healthcare is a right of everyone. WHO claims and swears by it. So we implement it, or at least try to…try to because with the given social politics, the primitive caste and quota system, which ensures who gets the benefit from the government, the disparity between the haves and the have-nots only increases. And fighting that long lain status that has integrated into our every culture and tradition, would be a judiciary nightmare.
What can we do to rectify it? Sound question. But unfortunately there are no sound answers.
We have all learnt the social, cultural determinants of health, but no one mentions the political games that farce into account. With a population our size, economy booming in and out like waves, media lapping each story like diamond, political parties and candidates only interested in numbers and fame, health insurance doesn’t seem a feasible match. To benefit each and every soul in this country, wide scale implementation of policies would be needed, a constant support from the state and national government and with individuals ready to lead the way for such enhancement. All doable on paper, on big screens and fancy presentations, but when it comes to actual sizing of the scale of expectation, there is virtually no progress. For as long as there are socially dividing barriers between us in terms of language, creed, color, religion, and norms defining how one belonging to a particular sect should be treated, there is no scope for a uniform health unit for all.
It is almost 2020, an age broadcasted as a time when millennial goals would have to be achieved by. And looking at the state of the health in our country, sadly, there is so much left for us to do, to create and serve. Miles and million miles to go before we can state that each and every person living under a roof or otherwise, would have the same right to healthcare as his/her neighbour without one. Maybe one day…in the near future, like how we longer discriminate people on their diet, we can achieve the same equality for healthcare.