Health is special. Many things we take for granted like shitting, shitting, sleeping, snogging(Harry Potter anyone?) are all related to good health. Our perception of the world around us is also largely dependent on our health and the health of our neighbours. Why, the infinitesimal extreme of bad health is death; and with death, everything we know comes to an end.
EVERYTHING.
Yet health care needs resources. They say health can be prized, not priced. But it certainly does have a cost like everything else. Like everything else, it needs Manpower, Money and Machinery (even more so nowadays). And although health is recognized as a universal birthright by all, there is scant regard for the resources.
Coming back to my earlier point, health means everything to us. And when everything is at stake, U put in your everything to save it. Natural, isn’t it? But then there are scores of times when people have their ‘everything’ at stake, so the phenomenon can be studied, analyzed and planned for. When U have everything at stake, prudence will still help you. Take for example, a young man with a family, and an income of Rs 3000 per month. His father has a known chronic renal disease, and is soon to go in for permanent dialysis, thrice a week. Now he is in a dilemma, because he knows that dialysis will cost Rs7500/week at least, and his father will live from session to session. Should he put in all his savings for the dialysis? The answer is personal, and obvious.
When Healthcare costs keep rising, we say that there is no other way but insurance. The group pays for the lone chance sufferer. Is it really cost reduction? At best, it is burden sharing, and at worst, it’s like adding fuel to the fire of rising health costs. This is because
A) Bad health is not, at many instances, a chance suffering.
B) Though the insurer can argue about the necessity of car repairs, ‘humanitarian’ beliefs don’t allow that in healthcare.
I am not in favor of the insurance companies; it’s just that how health insurance is different from others.
A simple fact finding exercise. Consider that U are not covered, and are on a regular medicine for some chronic ailment. A new medicine arrives in the market which says it is 10% better than the previous one, and costs only three times as much as the older one. And mind U the medicine could be ten percent better only in one aspect (maybe it just reduces the nausea U never experienced!) . Would U buy it? Perhaps no. Depends on the kind of money you have. But if you have insurance which pays you upto 1500 Rs/ month as medicine costs, would U care? You think you are not paying for it. Everybosy thinks so. The old drug is not available anymore. Minimum cost rises . Premium also rises. Who cares?
How many people we know would opt for a deluxe room when they are covered, and even a general ward when they are not. As the popular dialogue goes ‘Yeh paisa to Sarkari ha, apni jeb se kya jaata hai?’ (Hmmm Sarkari paisa.…Point for another write up)
And then there is the phenomenon of target pricing. U charge more to people who can afford it to compensate for the people who cannot. When U are not insured U cannot afford it; with insurance, U become wealthy!
Bottomline? Insurance causes healthcare costs to go up.
Let’s even take up insurance costs. We say it will make healthcare affordable for the masses. Masses? If U count people with a income of 2 lakh per month, then maybe. But it that so? Hardly 20% of our population qualifies for that. For others even a basic policy of 2 lakhs or so might gobble up 10% of their small income, which is not enough in the current state.
Solutions are still far away, but at least we have identified what the problem is, and what does not constitute a solution.
……………to be continued
