Public vs Private healthcare in India

As one of the world's largest and most diverse countries, India faces a unique set of hurdles when it comes to providing affordable and accessible healthcare to its 1.3 billion citizens. While the public healthcare system is intended to be the primary provider of medical services, many Indians still rely on private healthcare facilities due to long waiting times, inadequate infrastructure, and a lack of trust in the public sector.

Access to quality healthcare is a fundamental right of every citizen, yet in India, the healthcare system remains fragmented and inadequate. The country's healthcare infrastructure consists of public and private healthcare systems, each with its strengths and challenges. 

This blog will explore the world of public versus private healthcare in India, examining the advantages and disadvantages of each system and how they impact the health and well-being of the nation's citizens.

Government Healthcare Spending

Allocation to healthcare need not be redirected from other expense heads, but it is high time India gave healthcare spend the much-needed priority as what other sectors enjoy. The effective spend on public sector healthcare is below 1.5% of the GDP as compared to the 18% US spends.

According to the Economic Survey 2022-23 tabled in Parliament, the central and state governments' budgeted healthcare expenditures reached 2.1% of GDP in FY23 and 2.2% in FY22, up from 1.6% in FY21.

Increased primary healthcare spending not only confirms quality services at the grassroots level but also reduces the likelihood of ailments necessitating secondary or tertiary healthcare services.

Public vs Private Healthcare

Public healthcare in India is provided by the government and is free or at a minimal cost, while private healthcare is largely for-profit and often expensive. It is mostly concentrated in urban areas, and the quality of care is often high. The main focus of public healthcare is on primary care, which includes preventive and curative care. 

Private providers are usually highly specialised and offer a range of services from primary care to specialised services. It has grown significantly in recent years and now accounts for about 70% of total healthcare expenditure in India. There is a lack of regulation and transparency in the private healthcare system’s pricing and services. Here are the basic differences between these two:

Improving Healthcare Sector in India

Improving healthcare in India is a complex task requiring multiple stakeholders' involvement. The government has a huge role in increasing funding for the public healthcare system and implementing policies to improve accessibility and quality of care. The private sector can also contribute by investing in developing affordable and accessible healthcare infrastructure and services. In addition, civil society can play a major role in advocating for healthcare reform and promoting awareness of healthcare issues. 

Collaboration between these stakeholders is essential for ensuring equitable and effective healthcare for all citizens of India. Some potential solutions to improve healthcare in India include:

• Increasing the number of healthcare professionals
• Enhancing healthcare technology and infrastructure
• Implementing innovative healthcare financing models

India must prioritise healthcare reform to address the country's healthcare challenges and ensure that every citizen has access to quality healthcare.

The Preference for Private Healthcare Services

The quality of medical aid and excellence of service are the primary differentiators that have driven a competitive advantage private healthcare institutions are thriving on. When spending out of pocket, 70% of Indians would choose private healthcare services over a public institution.

Despite private healthcare being four times more expensive, 72% of rural residents and 79% of urban residents would not trust a public healthcare facility. The growth of private sectors establishments fuels the contemporary belief that infrastructure of a hospital can impact clinical outcomes, and the difference is stark!   

However, for financially marginalised and rural communities, there may be no other option. Public healthcare institutions receive funding from the government, making it mandatory for them to cater to all segments of the population. However, the services have been found to be extremely deficient. Only a minuscule 2% of Indian doctors service the needs of the massive rural population that further increases the dependency on private healthcare institutions.

In an irony of sorts, India offers a pool of well-trained medical professionals in the private segment along with globally competitive pricing, making it one of the most sought-after destinations for medical tourism. Growing at a CAGR of 22%-25%, the industry is expected to touch US$ 9 billion in 2020.

In the last decade, vast improvement in healthcare technology, especially in areas like telemedicine and medical tourism, has enabled the private healthcare system to flourish manifold. The private healthcare industry is estimated to touch Rs. 8.6 trillion (US$ 133.44 billion) by 2022.

The shift of the private establishment from welfare motive to business motive is no secret either. The cost of medical inflation in India was 7.14% as of 2018-19, almost double of the retail inflation levels of 3.4%. What this indicates, is that for the average Indian, getting medical treatment without adequate health insurance is no less than breaking the bank and compromising on the financial future.

Winds of Change

Implementation of the Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana (PMJAY) may reform the public healthcare system.  The government is looking to increase spends on healthcare at 2.5% of the GDP, which will reduce out-of-pocket expenditure on healthcare. Additionally, an estimated 1.5 lakh health and wellness centres may be set up under PMJAY.

The government also needs to bring in greater transparency and compliance to boost the quality of healthcare. An accreditation process needs to be implemented to ratify services across all public and private nursing homes/hospitals.

There is a need for accessible healthcare in rural areas that is qualitatively at par with urban services.., the vast majority of Indians who have little to no insurance need to look at investing in a comprehensive health insurance plan so that they are not left wanting in times of need.

FAQ

1. Is healthcare in India public or private?

Healthcare in India is a mix of both public and private systems. The public sector provides low-cost or free healthcare services, while the private sector offers more specialised and faster services, though at higher costs.

2. Which is better public health insurance or private health insurance in India?

Private health insurance generally offers broader coverage, faster claims processing, and access to a wider network of hospitals. Public health insurance, on the other hand, is more affordable but may have limited coverage and access to fewer hospitals.

3. What are the advantages of Private healthcare in India?

Private healthcare in India offers faster services, better infrastructure, specialised treatments, shorter wait times, and access to a wider range of healthcare facilities and doctors.