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Submitted: July 05, 2018

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Submitted: July 05, 2018




When it comes to caring for and treating poor patients in poor and developing countries, the only optimal destination is Government Hospitals as corporate hospitals are hardship pay for poor patients. But in Government Hospitals, the quality of health services are lacking.

How can we define the quality of health services?

The deficiencies in the quality of care represent as the failure of professional compassion, lack of necessary resources, gaps in updated medical knowledge, inappropriate applications of available technology, or in totality, the inability of Government’s Healthcare sector to change.

The urgency and situation of a patient’s illness should be properly addressed and appropriately attended on the emergency basis. Because all diseases go in one direction, if not treated; they grow from bad to worse and the result is mortality.  We all know that every suffering patient is not alive outside; he is lost in the anguish of disease.

The central government and state governments may have failed to align objectives, to measure clinical practice in Govt. Hospitals, or to link quality improvement to better health outcomes.

Another hurdle is all about order of priority in govt. hospitals.  There has been no focus on poor people’s health issues in developing countries.  Basing on the above cited explanation, we can judge the value of humanity in developing countries like India.  Governments ostentatiously declare proclivities of promises for poor and middle class patients by allocating special budget but nothing happens in practical. It is a political and election manifesto.

My endeavour in writing this series is to enable patients to take advantage of unprecedented access to information to become more diligent and informed about their health and medicine they ingest. I believe that one vital requirement for patient adherence to medicines is good patient’s knowledge about the medicines dispensed. In this aspect, both Health care, Pharmacies and Pharmaceutical sector are amply involved whereat Governments failed.

The average Indian is "quite poor", in simple words, 21.3% of Indians live on less than ?120/- per day earning.

Presently, the total expenditure on health care in India is below or around 1 per cent of the GDP. This 1% is also not reaching to actual sufferers.


White card, ration card, and Prime Minister’s or chief minister’s Fund special schemes are not reaching the poor and needy ones.

After GST induction, the medi-claim health insurance policies for the poor and middle class has become very costly by 3X. State government is diverting health care funds for their party fortifications. 

The growing power of the patient as a discerning consumer is creating new global markets and informing new models in Health care and pharmaceutical sector. Already in western and European countries, patients are demanding more sophisticated, convenient, transparent, affordable and personalised services. That is “the patient-centric health care sector”.

This study is worthwhile to dig deeper and understand anomalies.

Then, why not in India? 

An agile healthcare and pharmaceutical sector will have to be evolved to cater better services to poor Indian patients. Through perennial endeavour from every professional irrespective of sectors, the Indian Healthcare and the pharmaceutical sector can be streamlined, and gain strong momentum  in delivering good  health care services to needy patients.

  • Promote economical and affordable health check-up packages for poor and middle-class patients?
  • Consider the possibility of instructing private hospitals to give free treatment for cases like wounds, stitches or staples removed at a retail clinic or pharmacy?
  • Why don’t corporate and government hospitals ease up and get scanning and MRI at a retail venue rather than promote diagnostic tests on costly packages?

My underlying message is this; governments, Healthcare and pharmaceutical sectors must accept greater accountability and transparency. Of late, the good thing happened in India is, patients are welcoming the suppleness of medical technology.  

Through modern digital gadgets, obtaining readings from devices like electrocardiograms, pacemakers or defibrillators, which generally require an in-person visit, can now be done through a mobile i-phones and wirelessly sent to a physician.

But how many average Indian patients can afford to buy these digital gadgets?


Presently, the total expenditure on health care in India is below or around 1 per cent of the GDP.

Only answer to solve this dilemma is, more and more people should engage, discern and exert greater pressure on Governments, and influence on health care, and health systems for new models. At the same time, new products, services and delivery systems should help to democratise and decentralise health care.


An educated and an informed consumer will demand increasing accountability, integrity and transparency from healthcare and health systems.  We, as educated citizens of India, must bring a general shift from fragmented care to integrated care or model or transactional model, wherein patients can pay bills to positive results they get from the treatment in corporate hospital rather than huge and unbearable billings.  

Meanwhile, the pressure must be on the governments to provide sustainable care in the face of anticipated significant increases in healthcare costs.

The private sector must co-operate in offering partnership opportunities to satisfying patients’ demands. The private sector has the resources and innovative technologies to meet the outcomes.

I can boil the whole content down to a single adjective “erudite” approach. The level of knowledge of the patient about the medication is highly associated with the outcome of the therapy.

People should demand Governments for the Affordable Care Act. Rich can afford insurance, but the poor cannot pay under GST for mediclaim  health care insurance.

Aging population: There are nearly 118 million elderly persons (aged 60 years or above) in India; 60million females and 58 million males. Both the share and size of the elderly population is increasing over time. They are taking a greater interest in their care and are more willing to self-manage than earlier generations. People are expected to live longer than any previous generation, with many of them needing continuing medical care for the rest of their lives

From 5.6% in 1961 the proportion has increased to 8.6% in 2011. As people become older, they use a disproportionately large share of healthcare services.

A larger population of all ages also translates into a greater demand for health care providers. Where are affordable health care providers?

Every Indian knows that Government Hospitals, public healthcare centres and rural health service centres are the biggest flop in India.

The moment of what to do should come from people.

Well, healthcare talent management professionals will have to belt-up and shine up badges to battle head-to-head with their peers for health care privilege.

There is also an imperative need to firm up the biggest growth areas for health care employment like home health aides, geriatric nurses, physical therapists and similar jobs.  This is one way of creating employment.

Wellness connotes a state of overall health, while happiness is a more perceptual concept – how people feel about and experience their daily lives.

How many millions do get wellness and happiness from their daily lives as the plethora of diseases exists and yet governments care nothing about?

For all these, our economy must be strong. Yes, Indian economy considerably strong. It is estimated that Indian Economy will be bolstered up by Rs.13 lakhs cores from GST by the 2019 year.

Governments must meaningfully commit and spend for committed causes rather than waste away people’s tax money on political agenda.

More watch dog and autonomous bodies should be set up. Above all, every Indian should question and act true to the salt of his conscious on accountability and transparency of government.

We can predict great future changes within a decade, bound to happen in India.

  1. More affordable medical technology.
  2. More information must be available to the public on health care allotment and spending.
  3. The patient as the ultimate consumer.
  4.  Development of a patient-central delivery model.
  5.  Innovation driven by competition.
  6.  Decreasing cost treatment.
  7.  Increasing numbers of uninsured.
  8.  Less pay for treatment providers, payment on the relief basis.
  9.  The continued need for a new health care system.

To set a new direction to achieve these, the governments (Central and state) should try to improve efficiency by increasing cooperation between researchers, clinicians, and educators while demonstrating how they are “different” and “better” than the competition.

Happiness, wellness, and well-being, the terms get used interchangeably in developed countries.  Also, these words have a certain degree of awareness in sizable population countries, if not developed. 

But in countries like India, these words Happiness, wellness and well-being have no value in interchangeable interpretation in health context  in the given context size of the population, hungry politicians, government officers’ bureaucracy and red-tapism.

The light at the end of the tunnel is to make patients better equipped with knowledge about health care system.  We can bring about not only in the maintenance patients’ health but also in proposing, piloting, and advocating new systems that may inculcate habits of appropriate self-care.

I sincerely hope that there would be good days ahead for patients or persons receiving medical treatment in India; I presume that more demanding and discerning educated patients will be opening doors for new entrants in health care provisions.

In past and present regime, some proposed effective health care interventions are underutilized in India. Politics related disparities in use are large. It is argued that there is a need to go beyond the identification of broad strategies to design and evaluation of specific policy measures in regard to Health care insurances , free diagnostic access and if necessary free hospitalisation and medical dispensation for poor and middle class in corporate hospitals. Only through experimentation and evaluation will we learn what works in raising health care utilization, particularly among the poor and middle class in India.

“RAISING  PATIENTS' AWARENESS” is educating patients, empowering patients and helping patients how to manage their disease with self-care affordable systems rather than wait for inordinate delay-delivery of health care help.

To be continued in the next part.


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