HEALTH CARE – SHOULD GOVT PROVIDE, OR BEST LEFT TO PVT ENTERPRISE?
If the operative word is ‘SHOULD’ the answer is ‘OF COURSE’
Why? Because –
- It is what civilized governments should do. Along with providing security, power, education, infrastructure, rule of law, access to justice, and protection of our fundamental rights and civil liberty.
- It is what we pay our taxes for.
- It will protect us from rapacious profiteers who run the private healthcare mafia
The question now is COULD the government provide healthcare?
The answer again is ‘OF COURSE’.
Given the existing infrastructure, and the number of medical professionals graduating from state run or aided colleges at subsidized cost, who can be induced to work in the state healthcare system until they pay back their debt to the nation and the taxpayers, it is well within the scope of any motivated government to provide universal healthcare. Any budgetary shortfall can be easily filled by reducing the skimming off the top of government expenditure through scams by a few percentage points. Alternatively, if only a small portion of the evaded or illegal earnings stashed abroad are recovered, and /or tax evasion by the major players ignored a little less, this would be fairly easy.
I will refrain from the temptation to quote figures here as you are being bombarded with them by those who are waiting for a chance to get at a bigger slice of the pie.
The real question here is WOULD the government provide universal health care?
The answer is a resounding ‘NO WAY’
That would not be permitted by the unbelievably prosperous private healthcare mafia.
Health is the one consumer product that does not follow the laws of consumer rationality. People do not compare prices or haggle or look for best deals and extra freebies. In fact people prefer the most expensive treatments, procedures, hospitals, doctors and medicines that they can procure. People pay way beyond what they can afford and borrow heavily. Our family support system ensures that people get financial aid and non productive loans in the name of healthcare expenses. Friends, colleagues, neighbors, relatives all pitch in. Guilt is often assuaged by buying the most prohibitive heath care. The rationale is that we are doing everything we can for this persons wellbeing at a time of need.
The private healthcare system takes full advantage of this sentiment. Medical inflation is always at least five percentage points above the general inflation, and is not affected by economic factors. Crores are spent in getting admitted to private medical colleges and crores in bribes for state college seats, which the doctors have to recover. Millions are spent in getting licenses for these private medical colleges which are such money spinners. The Pharma Industry is a big brother of the much reviled tobacco and telecom industries in its clout to subvert government oversight. Mark up on drug prices are to the tune of 100 to 1000 percent. Plus there is very little liability litigation, as when this expensive substandard healthcare fails, we blame fate and say that we did our best, we went bankrupt trying to save him, but god willed otherwise.
The powerful people do not visit private Nursing Homes in India; they avail the best facilities available at state hospitals, which inevitably have the best and most dedicated doctors. They need not wait in endless queues and receive shabby treatment which is the fate of the ordinary citizen at these institutes. The taxpayer therefore is left to the mercies of the private institutes. It is the very poor, who has no alternative and can endure agony and indignity to avail his basic entitlement, and the very powerful, who know how to extract the most from the mammary of the welfare state that avail this state funded benefit.
No one is willing to kill this golden goose, so we are doomed to depend on the private sector for healthcare.