IMA Chief Calls Health Sector ‘Orphan’, Criticizes Govt Policies

Dr Asokan expressed disappointment with the lack of attention to healthcare amid the ongoing election season, noting its absence among the top priorities of political parties.

The chief of the Indian Medical Association (IMA), Dr R V Asokan has expressed deep concerns about the state of healthcare in India, describing it as an "orphan" sector that remains neglected by political parties and policymakers.

In a candid interaction with PTI editors, Dr Asokan highlighted several key issues plaguing the healthcare sector, including the underfunding of government schemes and inadequate investments in public health infrastructure.

Dr Asokan lamented the lack of attention given to healthcare, particularly during the ongoing election season, stating that health does not feature among the top priorities of political parties.

''Health is an orphan. Nobody wants to talk about health even after the COVID pandemic, where it was acutely felt even as a matter of internal security. We have not learned any lessons. We continue to be in the same 'all is well' zone,'' he said.

Flaws with Ayushman Bharat Scheme

One of the focal points of Dr Asokan's critique was the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme, which he described as "poorly structured and underfunded."

"It is underfunded to the extent that it will collapse. Why I say this is because it was envisioned by the prime minister for people below the poverty line, but perhaps it was structured by the NITI Aayog and bureaucrats,'' Asokan said.

While acknowledging the scheme's visionary goals, he pointed out fundamental flaws in its implementation, including inadequate funding and ineffective delivery mechanisms.

Dr Asokan expressed skepticism about the scheme's ability to fulfill its intended purpose, particularly in providing meaningful healthcare benefits to the intended beneficiaries.

Call for Increased Investments in Healthcare

Highlighting the woefully inadequate levels of investment in the health sector, Dr Asokan underscored the urgent need for increased government spending on public health infrastructure and human resources.

''As per the calculations that they themselves have given before the nation, we need at least Rs 1.6 lakh crore annually to run that scheme. It started with Rs 6,800 crore. And it is now Rs 12,000 crore. Whatever has been invested in health is too inadequate. People spend around 3.9% of their GDP on health. The Central and state governments put together spend 1.1 to 1.3% of the GDP, which is inadequate,'' he stated.

Referring to a 2011 report by the high-level expert group on Universal Health Coverage for India, commissioned by the former Planning Commission, Asokan emphasized the government's responsibility to provide a basic healthcare package to all citizens, regardless of their economic status.

He further noted that citizens could procure additional healthcare services beyond the basic package. The report also recommended strategic procurement from the private sector for individuals living below the poverty line.

Asokan expressed disagreement with the approach outlined in the 2021 report titled "Health Insurance for India's Missing Middle" by NITI Aayog.

According to him, the report suggested that 10% of Indians could afford healthcare expenses independently, 25% would benefit from the Ayushman Bharat scheme, and the remaining 90 Cr individuals would rely on private health insurance.

Asokan criticized this approach, stating that after a decade since the Planning Commission document, relying solely on the insurance industry for healthcare coverage is unacceptable.

Comparison with International Healthcare Models

Despite acknowledging the challenges facing India's healthcare system, Dr Asokan expressed confidence in its resilience and effectiveness compared to healthcare models in advanced economies such as the US and the UK.

He criticized the reliance on insurance-based healthcare models, citing the shortcomings of such systems in ensuring equitable access to healthcare services.

Dr Asokan praised India's public health infrastructure, highlighting the role of small and medium-sized hospitals in providing accessible and affordable care to patients across the country.

Preserving Entrepreneurship Spirit in Healthcare

Dr Asokan also raised concerns about the increasing regulatory burden on the medical profession, warning that current regulations could undermine the unique entrepreneurial spirit that characterizes Indian healthcare.

He emphasized the importance of preserving the role of small and medium-sized hospitals run by doctors, which he described as essential components of India's healthcare ecosystem.

Dr Asokan called for policies that support and empower medical professionals to continue serving their communities effectively.