Healthcare Industry – Business or Philanthropy?

Raviteja Innamuri, Consultant Psychiatrist, CMC-Vellore

It was February 2012 when I first met the co-founders of the Lexicon medical magazine at a conference in Mumbai. I was a young final year MBBS student, eyes brimming with dreams and vision beyond the skies limit. I flamboyantly ended my speech with the words, “Today, as medical students, if our goals are clear, only then, that vision 2020 will be realized.” Today I find myself a little uncomfortable to imagine that we are already in December 2019, a month before that 2020 arrives to question us. In fact, I do not even dare to recollect the VISION 2020 and the Millennium Development Goals.

When I was asked the question by team Lexicon on how I see healthcare – as a business or philanthropy, I began to ask several questions, myself. I believe that most individuals irrespective of who they are as individuals significantly transform themselves to fit in the system in which they are working. So, who am I? An Indian who has a responsibility to the welfare of my country and my people. A citizen whose education was completely funded by parents or scholarships from private institutions? A doctor fighting for justice and respect from society? A service provider for the clients who pay to see me every day? A father and a husband who is constantly worried about providing a good future for my family. I’m everything said above, feeling responsible, yet conflicted about what precedes another. Dharma-sankat of the mythologies is real, you see.

Irrespective of what I am or what healthcare should be, it is very much evident that health is now seen more like a business than philanthropy. Why so evident? Let me tell you why – just look at the symbol used for hospitals across India! Before I can explain this,  let us look at a few reasons that I feel has led to this current scenario.

1. The right to health as a fundamental right.

The system itself. There is a reason why it is highly recommended that some subjects such as education and health are best when under the control of the government. These are essential for the development of any society. Once turned into a profit industry, inequality and injustice creep in and societies fall. In India, there are more private than government medical colleges which therefore demand huge personal expenditure for training and thereby, efforts by practising physicians to earn back this money spent from practice. The only way out of this is the government needs to pump in more money into generating physicians who will in-turn serve their fellowmen. Similarly, more state-funded hospitals and efficient insurance coverage would be a welcome move.

2. The client

The consumer-driven industry has replaced the word ‘patient‘ with ‘client’. The customer now sees healthcare services like any other service. However, many clients with the voice have given-up on government-provided health services and they see their leaders also seeking private or foreign health services for their personal needs. Instead of allowing the out-of-pocket expenditure to push them into poverty, they need to raise their voices. Every citizen needs to see health as a basic necessity and need to demand good health services from the government and vote for leaders who see health as an important aspect of their agenda.

3. The service provider

The service-provider or the doctor is the most conflicted one. The one who is working in a capitalist world and hopes to lead a ‘good life’ like his engineer friend. The one who pictured himself to be serving freely in the village but returned to the metro as there weren’t even basic amenities to survive in the green villages. The one who now demands respect as he ‘saves lives’ but is not sure how much he should as his employer (the corporate hospital) has already charged the patient more than sufficiently.

Now, back to the symbol, I was talking about. Because a symbol denotes what we stand for.  A year after Lexicon was formed, one of the first campaigns undertook was to bring about awareness regarding the symbol wrongly flaunted by the medical fraternity. And not very surprisingly, the medical fraternity remains confused between Rod of Asclepius and the most commonly used Caduceus.

While the Rod of Asclepius (single serpent/ Guinea Worm with the non-­winged staff) is the deity associated with healing and medicine, symbolizing rebirth and fertility; the more commonly used – the Rod of Caduceus (2 snakes and a winged staff) is the deity associated with commerce, theft, deception, and death, symbolizing diligence and prudence, two characteristics very necessary in trading activities. The Rod of Caduceus (symbol for commerce) appears on the logo of almost all the health institutions instead of the Rod of Asclepius(symbol of commerce)!

As we know it, the art of healing is much more than a commercial activity. As we use the myriad of Greek/ Latin derivations in the language of medicine, we must be identified with the right symbol – the symbol that shines on our vehicles and glazes on the walls of our medical institutes. But even before we change these symbols, we also need to ask ourselves what are we willing to stand for.