We urgently need a regulatory authority for the Health Sector

We urgently need a regulatory authority for the Health Sector 

By Manohar Manoj

Like education, health is also one of the big sectors, which is abruptly ridden with corruption. For many years, on a trot, the reports of 'transparency international' (TI) found health as the most corrupt sector in India. These TI findings can be regarded as upright one because people feel the music of a corrupt health system in a more poignant manner. Health is a very sensitive issue, which is one of the most priority areas for any government, society, and families all. Like education, health is also being carried out by all three tires of democratic governments. Secondly, like education, it is also covered by public, private and NGOs. But, it is slightly different from the education sector on this count that in the health sector, we have not much difference between the private sector and NGOs. Most private hospitals run themselves on a charitable trust basis. In the name of charity, they get several incentives from the government but ultimately run themselves in a profitable manner. There are few charitable trusts working in the health sector, which run their operation free of cost on the line of the public health system. Thirdly, health also has many categories; firstly health centers/hospitals of which there are two types. The first type is the general hospital, which ranges from primary health centers to general hospitals; the second type starts from specialty hospitals to super specialty hospitals. The second is the availing of drugs and medicines and the third is health education, these all constitute the essential components of our health system.            Talking about the role of the central government, its role in the health sector is very much on the line of the education sector, under which it runs some super specialty hospitals, health institutions, and some medical colleges also. The central government also has a regulatory role in terms of the medical council of India (MCI), which is an organization giving professional certification to all medical degree holders as well as affiliation to any start-up of medical college.The central government has many health schemes, out of which the national immunization program is the most important. This program has got a huge success and has been instrumental in improving maternity health and child care in the country. This program has reduced the child mortality rate in a drastic manner and a bit has controlled the country's population growth. The Centre sponsors many health programs like the National rural health mission (NRHM), which has been hugely crippled by corruption. We know the NHRM scam in UP. In the same manner, as the affiliation authority, MCI has also been notorious for corruption and so its ex-chairman is facing a judicial trial over the charges of corruption.On the state level, mismanagement in the hospitals, corruption in the procurement and in the distribution of drugs, and negligence of duty, all have the status of corruption in almost all hospitals, whether they belong to any tier of governance or any public-private health system. The fact is that hospital management has always been on the poor side in any category of health services. Faulty health policies and a lack of full proof medical system have been instrumental to the emergence of multi-dimensional corruption in the health sector.Health is a service and an industry both. Doctors and all other medical and paramedical staffs render services, whereas the hospital buildings, medical equipment, and all apparatus, drugs, and medicines are part of the industry. We have corruption on both fronts. In government hospitals, doctors do not pay proper attention to the patient, they do not display proper behavior with the patients, and they lack involvement. Their applications always have been under the question mark. Private practice by the doctors of government hospitals has always been a big issue. Some state governments have made laws to bar their practices, but it went in vain.On the whole, there is still no equilibrium between the demand and supply of health services in government hospitals, so there is a huge rush there.The OPD(outpatient department) hours in government hospitals are always been inconvenient to patients. Therefore, on-demand quality health service has been just an unfulfilled dream for many. Medical services as well as medical education primarily come under the second tier of governance. Here we find that corruption is visible in terms of the inconvenience to the public also. Most government hospitals are not well equipped with the proper public convenience. It is lackluster on the part of hospital governance and the absence of maintenance and surveillance of various medical equipment. Admission of highly critical patients in the hospital becomes very tough there, whereas in private hospitals, huge charges are being taken and doctors are not very qualified there.Medical corruption has innumerable dimensions. The most notable among them is the prescribing number of investigations to the patients for any disease. This is a well-intentional act done by the doctors. Part of the expenses for several pathologies goes into the pocket of doctors. The pathological laboratory available in government hospitals have to face huge queues. People are compelled to do it from the open market. Second is the prescribing of medicine by the doctors which they have been dictated by the medical representatives belonging to a particular several drug company. Forty to fifty percent commission is being paid over the selling of any drugs and thus patients are being looted in the existing health system.Private hospitals are operating in such a manner that they can be easily termed a great symbol of corruption. Patients are allured, then cheated, misguided, and finally looted. All medical ethics are drowned while treating any patient. In child-born cases, where cesarean is not required, it is done just because of making money. Where a stunt is not required while bypass surgery, it is installed only to make money. An inappropriate amount of consultancy fees on frequent modes, unnecessary investigations, higher charges of beds, etc. have become modes of corruption in hospitals, whereas in the name of charity, these hospitals are being allotted land and being given several tax incentives, but they loot the patients.Kidney racket is also one of the prevalent ways of corruption, under which the poor, ignorant and needy persons are allured and cheated and then their kidneys are removed just with a few amount of money. Then these kidneys are transplanted to the needy for millions of rupees.Charging higher amounts of room rent has become one of the prevalent modes of making money in private hospitals. They just exploit the circumstances and conditions of patients, if they suffer from emergency kinds of things, these hospitals just try to grab the money as much possible from them, and Marta kya na Karta , a dying person can go to any extent. We have a large no. of cases when it has been seen, even at the fag end of life, the hospital kept them alive through artificial life support system, etc., and make their bills in lakhs.Pirated drugs and fake medicine has been also one of the most prevalent modes of corruption in the health sector. We have many scandals that took place in this regard. In states like Bihar and UP, many drug rackets have been found.Next corruption is related to medical education. For taking admission to medical colleges, there is a huge prevalence of capitation fee which ranges from 25 lakh to even one crore. Private medical colleges have been unbridled, so they take hefty money from the aspirants. These are the things, which make doctors, who studied here, corrupt. Therefore, these medical students go after big money while practicing their profession.Our health sector lacks policy and resources. If a public-private partnership model under a competitive regulatory mechanism is brought into the health sector, it will maintain a proper balance between both.Medical insurance has also become one of the new ways of committing corruption in the health sector. As we know, insurance is just a risky business, so is medical insurance also a business. There is a lobby in the health sector that supports the idea of spreading the network of medical insurance to the maximum level in order to suppress the effect of high charges being committed by private hospitals.The fact is that this lobby works for expanding the network of medical insurance all over the country, but medical insurance does not cover each and every health need of the public. Generally, in hospitals, the coverage of diseases for the insured's very selective; sometimes they are ready for cashless treatment, and sometimes not. Secondly, the corruption in medical insurance is the same as it looks in motor insurance. First, the client is not being given the proper coverage; second, the size of coverage is left over the whims and fancies and the discretion of the surveyor, in the same manner, it is up to doctors, how much disease coverage is he permitting over the insurance.The best method to provide health services to the public can be rendered only through fixing rates for all kinds of health services under some regulatory authorities. It will provide a level playing field for both public and private players as well as it will promote competition between public and private players.Decreasing morality and ethics in the medical profession has become the order of the day. Doctors have forgotten the sensitivity and service motto of their profession. There are many doctors who misguide their patients and also make them frightened. There was a time when the doctor's profession was just next to God because they were termed as saviors of mankind's life, but now doctors have forgotten all this and they are just after money. It is true that the growing commercialization of the medical profession has made medical education a very costly affair. As we often say that electioneering is costlier, so politicians succumb to being more corrupt, in the same manner after making lots of hard work in competing for medical exams and spending huge amounts of money on their studies, if someone becomes a doctor, he thinks about nothing but only money. I think medical education must be made easier and smooth and it must be diversified toward various other systems of medical treatment. For doctors, fame and glory are bigger things than money, so they must always stick to ethics and morals. One, who violates this, must be made ashamed of this.