Jean Drez's column: Health services in the country should not be driven by profits

I remember a scene from the film 'Hazaaron Khwaishein Aisi'. The angry workers want to kill the landlord. But when the landlord suffers a heart attack out of fear, they rush to his aid. But if the workers wanted to kill the landlord, why are they saving his life? Perhaps they feel that the enemy is also entitled to help when they are sick. Many countries have worked hard to ensure the right to healthcare. Soviet Russia was the first country to provide healthcare as a free public facility to all. In the 30s, Sri Lanka and New Zealand introduced universal healthcare. In 1948, Britain established the National Health Service, which to this day provides free healthcare to all citizens. Today, most of the developed countries of the world are providing free healthcare to all people in one form or the other. The main exception is the US. Many of these countries rely on health insurance to some extent to ensure universal healthcare. However, this is in the form of social insurance rather than business insurance. An example of this is Canada. Health insurance there is compulsory and universal. All residents are covered in a uniform health insurance plan. There are both public and private health centers, but most private health centers are not-for-profit. Even in other countries with social insurance, most health centers are non-profit, whether public or private. Beneficial health centers are strictly regulated. In India, government hospitals and health centers are said to have free healthcare for all. But in reality, these services are very limited and patients often have to pay for medicines or tests. Moreover, government hospitals are very crowded. When patients are frustrated with government hospitals, they head to private hospitals or nursing homes. They charge a hefty fee, but there is no guarantee that the services are good. Government-sponsored health insurance schemes have proliferated in recent years. Pradhan Mantri Jan Arogya Yojana provides health insurance cover of Rs. 5 lakh per year to about 60 crore people. There are also several health insurance schemes run by the state governments. Patients enrolled in these schemes can go to any health center. They have the right to receive free treatment as per the prescribed protocol. But many times private hospitals charge patients a fee. These health insurance plans, unlike social insurance systems, promote beneficial services. For example, under the Jan Arogya Yojana, about half of the empanelled hospitals are beneficial and about two-thirds of the funds are given to them. Health insurance further deepens the dependence of India's healthcare system on the business sector. Profit-driven healthcare is neither equitable nor efficient. It is not justified because it excludes poor people from healthcare. And, it is not efficient because the efficiency of the market mechanism depends on the ability of the consumers to assess the product. If you want to buy an umbrella, you can look at it first and decide whether you like it or not based on its design, color, material, price, etc. But when you buy healthcare, you can't see that 'product' in advance and be able to evaluate it in any case. You are completely dependent on the doctor. That is why there is so much exploitation in the private healthcare sector. If India wants to realize the right to health, it will have to invest heavily in public health services. There is no meaning of a developed India without good health. Ideally healthcare should be a public service, not a profit-driven business. The backbone of universal healthcare worldwide is non-profit health services. It doesn't make sense to grow without good health. (These are the author's own views)