A range of expert speakers will gather in Bengaluru at the IIM campus on February 18, to discuss challenges, trends, opportunities and policy directions for affordable healthcare in India (see agenda and registration details here). The theme of the event is ‘Building India’s Future Health Economy,’ with speakers representing a wide range of organisations: Manipal Hospitals, World Bank, National Institute of Public Finance and Policy, Ministry of Health, IIM-Bangalore, Acumen Fund, Himalaya Drug Company, Indian Institute of Health Management Research, First Life, Bosch and Silver Oak Health.
The organising team includes Benedict Paramanand, Editor, SustainabilityNext; Manoj Chakravarti, COO, IIMB; and Anil Misquith, Executive Director, Strategic Initiatives, Samhita Social Ventures. Here are some insights from some of these experts, with more debate and discussion coming up at the Conclave.
Most of healthcare, especially tertiary healthcare, is in the private sector and obviously very expensive and way beyond the reach of the common man. “Except for some premium institutions in the public sector, the facilities and services in public sector are inadequate,” explains Dr. H. Sudarshan Ballal, Chairman, Manipal Hospitals.
“Insurance and third party payment do not cover the vast majority of our citizens and most of the expenses have to be borne out of pocket – unlike in the developed countries. Hence, there is a huge burden on the common man in India,” Ballal adds. There is also an acute shortage of medical, paramedical, nursing personnel, and hospital beds in the country, especially in rural areas.
“Mental healthcare is largely unaddressed worldwide, particularly in developing countries. Depression is ranked only next to heart disease as the leading healthcare challenge in most countries, including India,” explains Sushil Eapen, CEO of Silver Oak Health. Founded in 2015, the Bengaluru company specialises in behavioural challenges like anxiety and depression.
According to the World Health Organisation, around 450 million people around the world are undergoing various mental health challenges. In India, reports from NIMHANS indicate that an estimated 30 million people above 20 years of age experience depression challenges that require treatment, and among the geriatric population, nearly 21 percent undergo depression with co-morbid diseases, according to Eapen.
In the mental health sector, the top three challenges are affordability, convenience and privacy. Telemedicine can make notable contributions here. “In most parts of the world, there is social stigma attached to mental health matters, and so technology-based delivery of mental health services will allow more people to avail such services and get back to productive lives,” explains Eapen.
Economic development in India and opening up of the market has lead to an emerging middle class that has the resources to access and afford healthcare. “Certainly, both the government and private sector are working on increasing the health insurance coverage and the penetration is far more than what it was decades ago – even though we have a long way to go,” says Ballal of Manipal Hospitals.
Awareness about health related issues has increased, and many modern state of the art hospitals have come up in the nook and corner of the country so that people can get advanced treatment close to where they live. “Technology available anywhere in the world is now available and advanced health care delivery like robotics, transplants and so on can be performed here at a fraction of the cost abroad,” adds Ballal.
There are also a number of emerging opportunities in the area of human cognition. “The information load on people is increasing rapidly, and there is growing interest to sharpen brain’s cognitive abilities like working memory, attention and reasoning. Improvement of these areas can have significant impact in academic performance in children, as well as job performance in adults,” according to Eapen of Silver Oak Health. Technology allows many of these interventions to be delivered to people at the convenience of their homes.
The road ahead
There are numerous opportunities ahead for entrepreneurs and major healthcare players; policymakers will play a key facilitating role here. “Entrepreneurs should invest in technology to make healthcare available at the door step and focus on remote monitoring, home care and health awareness programs,” advises Ballal of Manipal Hospitals.
“If you are confident about your abilities, pick an area that you understand and identify a gap where the needs are underserved and come up with a plan to deliver products or services better, faster and more affordable to customers. I recommend that you take these ideas in your head, form teams, take some risks, and plunge into entrepreneurship,” advises Eapen of Silver Oak Health.
“Don’t be afraid of failure. You will learn a lot. If you succeed, you will look back and say that it was the best decision at that time. If you fail, you will be better prepared to start something else or even if you go back to a job, you will be far more valuable and well-rounded to create better value for your employer,” adds Eapen.
More hospitals should be built in Tier II and Tier III cities. “Industry players should encourage use of generic drugs and less expensive consumables, especially made in India goods. Strict ethical practices are needed within the health care sector,” urges Ballal.
Policy makers should focus on preventive and primary health care, and universal coverage, especially for the less privileged. “Government should incentivise rural health care and go in for private public partnerships for tertiary care. They should increase health care spend in India, which is dismal right now even compared to other developing countries. Duties on imported life saving drugs and devices should be decreased or abolished,” advises Ballal.