Health care reforms in India too need reforms as we need reforms in many other sectors: electoral. police, judicial and administrative.
6 decades of free health care policies in independent India have not brought succor to the larger percentage of population. Those at the base of pyramid do not have access to the basic health care. The central and state governments have spent massive amounts on opening and maintaining large hospitals to small dispensaries: the services are more or less free. Yet we have dismal performances being seen: they are best characterized by inefficiency, maladministration and waste of resources and poor work-ethics.
What is the solution: open more efficient hospitals? No, stop spending further money on this wasteful exercize. In my opinion, the following steps should be taken:
1. Govt hospitals be replaced with health insurance: Open no more govt hospitals, rather gradually abolish this system. Government must provide health insurance cards to each and every family. The concept of sliding scale in deciding premiums can be applied: to the families below poverty line, these insurance cards can be free , while those with high incomes, the premiums can be higher. Families can be given the option to opt out.
Any person with health insurance can get health care from the eligible health facilities (generally, private sector).
2. Regulate private health sector: Let the private health care sector prosper, but the govt must bring in strict regulations how the clinics, nursing homes and large hospitals operate. The current private health care sector in India is highly un-regulated, hence malpractice is prevalent. They often exist to reap maximum monetary benefits, while quality of health care and ethical practices are generally given low priority. A highly regulated system will help curb malpractice.3. Govt to provide public health: The government must continue to provide preventive health services: vaccinations/immunizatiions, ante-natal care,etc.