Every human being in any country should have satisfactory health care. We must have clear-cut policies in developing a good and acceptable health care system. It is unrealistic to expect the government to underwrite all the costs of medical care given to everyone. Those who can afford to purchase private health insurances should pay for their services.
Every employer should provide health insurance coverage as part of the premium to be paid by the employees and manage basic co-payments. The state and Central government who are major employers should take a lead in this respect. Retired Army personnel should be provided with total subsidy by the Central government.
When we do all these we have to make sure that the tariff for the various medical procedures and professional charges and their limitations are predetermined.
In spite of all these a good segment of people will have no health insurance coverage or employment benefit. The new government should ensure children under 14 years of age and all adults over 70 years and irrespective of any age all disabled and handicapped individuals, will come under the Central government health care system, which will be orchestrated by eminent professionals in medical and administrative fields. Each of these persons will get an identity card that they will carry and will be assigned to a primary care physician/pediatrician/surgeon for their medical needs.
Need for medical professionals in rural areas
India has about 340 government and private medical colleges and over 30,000 MBBS graduates pass out annually.
Even while doing their MBBS the medicos plan for specialty or super specialty education. They are neither ready nor willing to practice in rural areas. At best, those who stop with MBBS want to work as medical officers in city hospitals for gaining experience. Needless to state a sizable percentage go abroad for further education or employment opportunities.
I have a couple of suggestions:
The government and the Medical Council of India should authorise 10 more seats in each medical college. All these students will receive full scholarship and hostel fees from the state/local and Central government. These students will be sponsored by specific Panchayats selected from among the local schools. The students after graduation will serve the Panchayat Hospital for 5 years after which he/she will be in a reserved list for PG education.
Nursing colleges/pharmacy colleges, physiotherapy colleges and allied health science graduates are growing in significant numbers. Because of limited career opportunities many of these colleges are functioning with less than the sanctioned numbers and some have folded up. One of the problems expressed by these graduates is that it is mostly a close end job and many of them are unable to look at themselves doing the same thing in the long run.
Incidentally all of them have learnt a fair amount of medical care, at least in their own fields besides common introductory level preclinical and para clinical subjects. If only these people are given an opening to do a short term condensed medical diploma course after 5 years of practice in their area (say 2 years in hospital based institutions) and recruited to serve rural clinics, many of them may come forward. Here again scholarships and other incentives besides an assured good salary will encourage more to follow.