Demystifying healthcare

Even though human life and the progress of civilization is pivoted so strongly on health care, it remains an area that has much to be demystified and every layer that adds to the conundrum in the sector needs to be analysed. The behemoth needs to find the right junctions and intersections of medical practitioners, infrastructure, pharmaceutical industry, medical equipment makers and above all financial investments to thrive and achieve what it wants and ought to achieve.

According to the WHO’s description of fundamental human rights, “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.

The universal right to health implies that all people, no matter where in the world, should have access to the services and care they need, when they need them, without draining their savings or going bankrupt. While this is a fairly straightforward concept, over the years, healthcare has transformed into one of the most complicated aspects of our lives.

The intricacies of the healthcare ecosystem, both in India and across the world, have given rise to a burgeoning industry that thrives on complexity. This complexity is paradoxically a result of the misconception that healthcare is a linear sector that lies in the hands of just the medical fraternity to push ahead. The lack of a matrix mapping all key players and factors that are well embedded in the socio-economic fiber of society has made it into a mammoth that remains wanting concerning the fulfillment of this basic human right. Crumbling at places due to its size and lack of productive junctions has resulted in poor healthcare infrastructure, inadequate funding, low quality of care, high costs, and most importantly, a lack of access.

Despite significant strides through innovation and R&D, endorsed by the short time effective response by key health care players during the pandemic, there is significant inertia that prevents universal care for all.

The major roadblocks to demystifying healthcare and successfully un-layering its daunting complexities are time and resource crunch. However, for the healthcare segment to be more organized and coordinated, there is an immediate need to have a policy framework that effectively envisions healthcare in a streamlined and cost-effective manner. There is no option, if all stakeholders- patients, investors, health care workers, medical institutions and care clinics are to achieve what they want and ought to achieve.

But how does one go about tackling decades worth of complexities related to funding, access, quality and more?

Direct Consumers

Direct consumers in the healthcare industry range from outpatient and inpatient care, to consumers of over-the-counter interventions including drugs and devices, the medically insured, and more. There is infant to elderly healthcare, reproductive to accident-related health response systems, further heading to complex and new diseases and disabilities.

The top strategies that can be adopted at a short time range may include steps that look at segments and also take a multi-pronged approach:

  • Resume: Schools, colleges, and other institutions must implement thorough, industry-approved curricula related to healthcare, to effectively educate and inform the masses about the basics of hygiene, diet, nutrition, physical fitness, and mental health. In India, lifestyle-related diseases have replaced traditional health issues. With rapid urbanization and the demands of modern life, about 50% of spending on in-patient beds is for cases of lifestyle-related health issues, including high cholesterol, blood pressure irregularity, obesity, poor diet and alcohol consumption. Practical and theoretical studies of healthcare needs, interventions, and more must be institutionalized, to ensure effective response and management of good health practices from the very beginning, lowering the need and cost for future interventions.
  • Outreach and Awareness: Much like any industry, healthcare standards review day by day, better illuminated by research and technological innovation. To keep the public informed, pathways of consistent communication must be set up for service providers, policymakers, especially harnessing the metaverse and the digital boom in countries like India where even the lowest rung has access to data and information. We must speak the language of the people moving beyond generic information related to public health, hygiene, and changes in the industry to keep the masses up-to-date with new policies, interventions, and initiatives.
  • Technology and Gamification: Health begins at home, with the individual. To promote health norms and best practices for individual care, there is a need for the proper promotion of health gadgets and gamification tools that aid in both creating awareness, and autonomous health-management strategies.
  • Telemedicine: One of the biggest hurdles to receiving timely and appropriate care is a lack of access to affordable consultations. Telemedicine is a useful tool in bridging the rural-urban divide of medical facilities, extending low-cost consultation and diagnosis facilities to the remote areas via the internet and telecommunication. Familiarizing the public with telemedicine and digital consultation norms, especially in rural areas with a dearth of medical health professionals, can go a long way towards getting people the care they need when they need it, and without breaking the bank.
  • Alternative Medicine and Traditional Interventions: A nation known for its history with alternative medicine, wellness practices and more, including Yoga, meditation, allopathy, Unani, Ayurveda, and other traditional methods of treatment, the Indian public must be made aware of at-home, natural and physical interventions for a healthy lifestyle. Increasing public awareness and investment in these areas would go a long way towards avoiding expensive interventions and care required later on in life.

Healthcare Service Providers

Providers of care can range from doctors to consultants, institutions, policymakers, insurance providers and more. To achieve universal health care, aligning service providers at every stage of the process is an inevitability and compulsion.

We need to create and collaborate through:

    • Care Pathways: A care pathway is a multidisciplinary healthcare management tool that addresses the healthcare needs of specific groups of patients with a standard clinical intervention course like what has been already done in the case of cataract surgeries and root canals. Care pathways ensure that the varied clinical interventions by professionals involved (including physicians, nurses, physiotherapists, pharmacies, and more) are meticulously defined, optimized and streamlined down to the hour or day. The promotion of care pathways would allow for service providers from across the board to channel the care load effectively while optimizing costs, and timelines.
    • OPD Insurance: OPD or Out Patient Department cover is a relatively new feature offered as a part of health insurance policies by certain providers, including ICICI Lombard, Bajaj Allianz and more. While a majority of insurance providers only cover hospitalization expenses, Out Patient Department expenses, including doctor’s consultation fees, health check-ups, pharmacy bills, dental treatment, diagnostic tests, and more are usually left to the patients themselves. The promotion of OPD insurance policies would drastically reduce costs for patients and improve access to affordable, quality care, while also streamlining patient triaging and eliminating inter-departmental bureaucracy.
    • Welfare Associations and Medical Assist Escort Services: Community support programs, such as Resident Welfare Associations and Group Associations for Public Health would go a long way in this process, They will also look at medical assistance for getting appointments, medicines, home medical staff through escort services within your community.
  • Co-Development: Unlike most countries where public spending dominates the industry, India’s private sector accounts for 70-75% of healthcare spending; hence coordination and harmonization among the plethora of players is a must for universal health care. In a recent trend, key industry players are joining forces with a focus on start-ups to collaboratively develop new and innovative healthcare solutions. To demystify healthcare for the common good, these co-development initiatives must make a concerted effort to involve the public in their partnerships to create a two-way street of information exchange that would benefit both public awareness and result in value addition.
  • Dedicated Policies and Interventions: While scaling up hospital companies, ancillary businesses like third party diagnostics, retail pharmacy and digital business is essential to our overall healthcare infrastructure. A must have is a blanket policy that breaks down and standardises each step and segment to mitigate complexities from one treatment intervention to another. User and patient friendly services all the way.

Thus like I said while healthcare presents itself as a daunting and complex subject, the reality is that it needs immediate focus from all stakeholders. We all must come together across demographics, socioeconomic status with a strong streamlined process and players must determine the course towards making health care accessible, simple, and affordable for all.



Views expressed above are the author’s own.



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