Medical Services for All

India is a growing economy with emerging intelligent and talented people who are rendering their services mostly to the west either directly staying there or offline from India, particularly Bangalore. Lot of Bangalore IT companies develop software for American, UK or German insurance companies. But, our own country is deprived of these kind of insurance to all. People who work in IT are covered by their companies. Government employees are covered by some schemes or the other. Few factories are covered by CGHS scheme.

But, majority are uncovered. Examples include small garment factory workers, petty shop keepers, unemployed citizens etc.

Recently I saw on a TV channel where a small 9 month baby was suffering from heart disease and was admitted in KR Hospital, Srinagar, Bangalore. This baby boy is the only baby for their parents. His mother is a Garment factory worker working in Nayandahalli earning 3,000 rupees a month ($60 a month). She is divorced to her husband who is married to another lady after the divorce and not supporting this baby's medical expenses.

Baby was kept in ICU and the medical expenses was 5,000+ ($100+) per day. Also, baby had to be operated which costs around 2,50,000 rupees (nearly 6,000 US$). She is not covered under any insurance scheme, nor does the hospital gives any concession. How can she manage? She spoke helplessly to the TV channel. I felt helpless.

I felt the basic question, why all of our citizens are not covered under insurance scheme? The scheme followed by United States is one of the worst scheme where only aged is covered. Those who are not insured cannot afford medicines. This makes doctors rich due to insurance companies, people should be fully dependent on insurance companies which will be covered through their employers. I believe same culture is beginning to happen here in Bangalore. The Apollos, Mallyas and Wockardts are all unreachble by a common man. They are entertained only due to the medical insurance paid by the insurance companies. They charge unreasonable charges to the services they offer.

Today, I was just surfing channels and I saw a program on the Australian Network channel where the anchor told the worst thing of the American Medical system and he wanted to see how the medical system is operated in other countries. Few of the countries which he mentioned good was

1. United Kingdom

2. Japan

3. Germany

and the best of all Taiwan.

United Kingdom has got private doctors, usually general physicians, who are paid by the Government Insurance company for treating each and every person. They have a bridge telephone line as well as chat window open with subject specialists such as Neurologists and Nephrologists where these general physicians can get special advice and treat the patients. Prices to the doctors are negotiated once in 2 years or so. Praja members from UK can update more on this or we can find out from Wikipedia or some other source. Drawback is there is long wait in the queue since there are fixed number of doctors.

Japan comes second. Here, there is no concept of Government doctors. All the hospitals in Japan have fixed prices. The price list goes from a wound of 1 inch to major heart surgery. Everyone is covered by the insurance. He was telling there is competition among the private insurance companies to offer services to the Government. I couldn't understand the concept. Every 2 years, major doctors,hospital heads and pharma companies are invited for a conference and the prices are renegotiated.

Germany has got a concept of Government insurance for everyone. Rich can also go for private insurance. There is a concept where the rich pays for the poor's health. I couldn't really get how it works. Even in Germany, prices are fixed by the Government.

Taiwan studied all the countries system and implemented a system which took the flaws. Everyone is given a medical card. There is a single medical insurance company which will be changed periodically based on the service levels. This card is directly billed to the insurance company just like what many IT companies here in Bangalore do. There is a limitation of 20 visits to doctor per month. If more than 20 visits by the patient, he will be consulted by the Insurance Company. Prices also are standard in all hospitals just like Japan and negotiated by the insurance company.

Why can't we have a system like this and save many lives like the small baby whose mother cannot afford to get it treated?