THE BLOG

Indian Healthcare Needs Affordability, But Not At The Cost Of Quality

The price cap on stents, for example, has been counterproductive.

07/06/2017 9:08 AM IST | Updated 07/06/2017 9:08 AM IST
Adnan Abidi / Reuters

From being a desired destination for medical tourism (1,34,344 foreigners visited India in 2015 on medical visas), India is sadly heading towards a situation where there is a sudden exodus of Indian patients seeking healthcare services abroad. While the Centre has been rolling out initiatives to attract medical tourism, ironically, a number of Indians have been flying out of the country for medical services. Last month, for instance, there were reports of Union Minister Ram Vilas Paswan flying to London for heart surgery. Early this year, Congress party president Sonia Gandhi had flown abroad for medical tests and treatment, details of which remained undisclosed. The fact that our leaders feel the need to seek medical services outside the country hints at a rather disturbing state of affairs. The government may merely be paying lip service in its claim of implementing measures to prioritise and improve the healthcare system in India, if our very ministers have scant faith in it.

[P]atients from India are flying to neighbouring countries... for the implantation of cardiac stents, where the differentiation in the quality of these medical devices still exists.

India's extremely high incidence of non-communicable diseases is widely known, accounting for 60% of all deaths. In a country grappling with cases of diabetes, hypertension, and cardiovascular diseases on the rise, the immediate focus must be on making good quality healthcare accessible. India is catapulting towards being a technology hub, and is not far from becoming a global power. The country has to tread a long path, however, in terms of healthcare where its budget continues to be a negligible 1.3% of the GDP; 70% of healthcare spending in India is out-of-pocket.

The government's recent decision to put a price cap on coronary stents, implemented with well-meaning intentions has not necessarily been in the best interest of the healthcare sector. An eminent cardiologist in the country recently said:

"In the absence of robust quality control regulations in the country, there is a strong possibility that the fineness of stents may be undermined. Since all stents are not the same, their prices should be categorised on the basis of their quality. Because of the government move, one cannot use a high-end stent even if one so wishes in India."

By extending the narrow capping mechanism to include manufacturers, the health industry runs a massive risk of losing out on numerous counts. The multinational manufacturers that invest heavily in R&D may well be discouraged to do so hereon, imposing an impediment to any potential advancements in technology. In addition, the local manufacturing sector for medical devices has not quite developed yet to sustain the market on its own. Importing raw materials and latest technology may no longer be feasible, leading to poor quality stents finding their way into the market. Accessibility and affordability, while central to policy making in the health sector, cannot overpower concerns over quality. It is not just people from abroad today, but even patients from India who are flying to neighbouring countries including Nepal and Thailand for the implantation of cardiac stents, where the differentiation in the quality of these medical devices still exists.

Any move to impose price caps on medical devices without a fair mechanism in place will... have the detrimental effect of stunting innovation, research and development.

On the heels of this price cap is the newfound and justified anxiety over possible price caps of other essential medical devices such as hip and knee implants. The government recently extended tax sops to Apple, even as the industry in the healthcare sector struggles to provide high quality medical devices in the absence of manufacturing or import incentives. This helps drive home an integral point – that we may need to work on our priorities as a developing nation with a 1.3 billion population, more than half of which does not have access to quality healthcare services. Any move to impose price caps on medical devices without a fair mechanism in place will be short-sighted, and will have the detrimental effect of stunting innovation, research and development.

Vinod Khanna: A Style Icon

More On This Topic