The Indian Healthcare Industry - Past, Present And The Future

India has witnessed dramatic changes in various sectors since independence particularly after the post liberalization period. The economic reform and the government policies have been helping the economy and certain industries on various segments. The health sector is no exception to this. A good health is the primary concern of every individual and also for any government. A country’s economy can grow and be healthy only if its people are healthy. Providing and safeguarding the health of people should be one of the primary concern of a government. How has India achieved on this front? Its no doubt that the Indian healthcare sector has grown robustly in terms of technology and more number of hospitals. Privatization has helped to achieve this. Both these factors are vital and very much essential for a developing nation like India. Fortunately, India managed to achieve on this. But still as it is common in all the other sectors we face constraints and leakages in this sector too. Why? This cannot be taken lightly as it is the most important sector compared to others. Let us see how we have been progressing on various points concerning health.

India has always given importance to health since early ages as many medical practices have its root here which is growing popular even in the western world. Even during the pre independence period our emperors always had a health physician in their empire. India is known to cure many illnesses with its easily available natural ingredients like neem, turmeric, honey, aloe vera etc. This natural way of treating illness has gained attention among the western countries as it has been effective and cheap. Many form of physical exercises like yoga and kalary (the Indian martial art) is followed and learned by many foreigners now. India is known for its increasing huge population. Hence it is really important to take care of this growing population. The main driver of this sector is the growing population. The country has more number of young people. There is a wide gap between younger generation and older generation as the former dominate the mass of the population. This makes India a powerful and dynamic economy with more number of people being under the productive age. This stresses the fact that it is important to provide improved health facilities. When it comes to health facility we seriously lack in providing good access to health. The primary reason for this is we have very poor R&D which is not encouraging innovative and quality products and services. The reason for more number of hospitals is the new economic policy that encouraged private players and India’s obsession with infrastructural development in the recent years. We rank way behind in Human Development Index (HDI). Surprisingly, we have gone ahead in this ranking last year because of improvement in the life expectancy. Thanks to increased health care and other factors like changing lifestyle, our life expectancy has increased.  Healthcare has always been India’s one of the largest sector in terms of revenue.  India being an emerging nation constitutes more number of middle class people. Though India took the path of industrialization it is still considered as an agrarian country with the rural population being nearly three quarters of the entire population. And almost 27% of the people live below the national poverty line. Considering this, India’s health policy is targeted towards these people to get access to medical facilities and medicines at affordable price.

By considering all the factors surrounding the development of the Indian health sector we have come a long way in achieving the desired results. However, there are still some loopholes and problems that we need to sort out for the welfare of the people.  Development and growth as in all cases comes with exploitation. The bad part here is that it is the people’s health and money that is at stake with such exploitation. The growth of the Indian health sector reached its high since the new economic policy. The increased privatization and liberalization policy contributed to this high growth which encouraged commercialization of the Indian healthcare sector. This aspect of commercialization of health service has come with bad economic cost. We the people are the one worst affected by this process. As we are an emerging nation with huge population we are prone to hereditary disease and every day we hear some new disease and medicines to cure those diseases which are mainly because of the change in lifestyle and external factors. There is increasing level of deaths and diseases among men around the age of 30 to 40. Women also face huge health risk because of the increased work pressure and stress. Today both men and women go to work leaving their children at home who with no parental guidance and less time to be spent with their parents tend to indulge in bad habits that causes serious threat to their health like obesity and psychological disorder. Many diseases today manifest into multiple diseases finally affecting all the organs of the body. For example high blood pressure increases the risk of heart attacks, strokes and kidney failure. Because of this not only the patient but also their family members undergo a great trauma. The average expenditure of an Indian to buy medicines and get health services have increased manifold. This puts a huge financial burden on an individual that eventually affects savings and the real income.

The truth is that most of the diseases in India are preventable and curable. But still we see high mortality rate particularly among infants. As we know the diverse nature of our economy, India has the potential to address many of its challenges with its unique home grown resources. Considering this, it is really hard to accept that India loses 4000 children under the age of five everyday. This figure is really hard to digest for a developing country. India accounts for the largest number of deaths of infants primarily because it has failed to provide them and their mother’s access to critical health care. The vulnerable sections of our economy find it difficult to meet the expensive sophisticated medical treatment. Though the government hospitals provide services at affordable prices they lack in providing efficient and immediate treatment because of which we lose more number of people. India has the attitude not to talk about healthy practices publicly since the age of our great ancestors. This has reduced the awareness of many heath related issues and is considered to be the main reason for this huge mortality rate. However, the situation is now different.  People especially the next generation are being increasingly health conscious. The internet and newspapers regularly throw light on health related issues helping in creating awareness among the public. Thanks to globalization and the internet era all information is within reach. As our country is vast, the states have shown wide variations in some of the key health indicators. Tamil Nadu, Maharashtra, Karnataka and Andhra Pradesh have reduced their infant mortality rate by 7.25% of the national average. Haryana and Bihar with a decline of just over seven percent, manage to touch about the national average. Jharkhand, Rajasthan, Madhya Pradesh, Punjab, West Bengal and Uttar Pradesh are just below the national average. The Maternal Mortality Rate (MMR) has decreased steeply in the last five years. This variation in heath indicators is because of the wide disparities in healthcare services within the states. Its high time both the Centre and states address these disparities in order to achieve its 12^th plan goals.

Globalization has helped our healthcare sector in more than just one way. The information technology sector has transformed the country’s economy and is currently helping expand access to a wide range of quality services for some of the poorest in India. To what extent we have benefited from this technological advancement? A country like ours with such a huge population and disparities among different class of groups cannot be totally acquainted with such rapid technological development unless we formulate our health policy targeting the vulnerable section of the society. There is a lack of transparency in our healthcare sector. Many people from the rural areas who come to city in search of treatments that they don’t have there are prone to fallacies and medical marketing here. People from the poorest group with no awareness and primary education sometimes fall victim for the advanced medical treatments. The technological advancement has sure brought good infrastructure but not those feasible medical treatments to all. All families in India deserve equal access to health innovations that could help and protect children. It is unacceptable that children in India die of preventable and treatable illnesses. Some diseases that affect children are life threatening for example children who suffer from malnutrition are more vulnerable to the causes of diarrohoea which in turn perpetuates malnutrition and leaves children prone to infections. Its really unimaginable to see children dying of malnutrition in this 21^st century.

How has the pharmaceutical industry helping our healthcare sector in providing access to important drugs and medicines?  The pharma industry is the little brother of the healthcare industry. The Indian pharmaceutical industry is very small as the industry is dominated by the foreign players and there is little scope to the domestic players. However, the situation is changing over time by effective policy reform that is encouraging domestic players. Having taken global strides in the past, the domestic pharmaceutical industry now finds itself in the thick of history in the making. Many prominent domestic companies like Ranbaxy, Anji Reddy and Biocon have been benefitted and making marks in recent years since India amended its patent act in 2005. The pharma industry in India finds itself at the base of steep climb. They are finding it difficult with increasing cost of research and enforcement of Intellectual Property (IP) rights. IP protection is the key factor in the global arena as companies protect data in the course of their research and innovation. There are covert moves in the global pharmaceutical industry involving IP. And a constant worry for the local drug makers is whether such property is being secretly brought into the trade framework. The recent move of Supreme Court by rejecting the patent plea by Novartis is welcoming and appreciated by many in the industry that allows to produce generic version of expensive drugs made by foreign companies. Its really nice to hear that India encourages local drug makers to manufacture generic drugs that are cheap and affordable. India is also the world’s biggest provider of cheap medicines. Though this fact is all that encouraging, it does not bring joy to some people. The TV show Satyamev Jayate hosted by actor Aamir Khan threw some light on the dark side of the Indian health sector. People in some states were forced to buy costly drugs prescribed by the doctors. Though the government has been motivating the domestic manufacturers, big hospitals are running behind reaping profits by not prescribing generic version of the same expensive drugs. The global drug prices are heading upwards as a result of increasing demand in the global market. In such a scenario producing generic medicines help in a long way. The Indian companies like Natco, Glenmark, Cipla and others are constantly fighting over the patent related battles by the foreign MNCs. Considering the fact that our country is still an emerging nation with great challenges generic drugs do more good than anything.

There is tremendous scope for the healthcare industry in the near future. The industry is bound to see developments on various fronts as a result of the ever increasing population, medical tourism and unconventional thinking of the domestic players for better operations. Good health policy and the government opening up its arms to Public Private Partnership (PPP) will be the key factors which would drive the future of healthcare in India. The insurance companies play a key role in the development of the healthcare industry by providing good health insurance for the wider audience. If this happens then there will be immense opportunity for new and existing hospitals across the country to reorganize their structure and lure their customer base as the competition is likely to get headed up soon. This means, the patients have a lot to choose from, being insured. The senior citizens will be provided space and access to advanced medical treatments once they get hold of a good health insurance that provide them with good benefits. According to a report by Mc Kinsey, Indian healthcare industry will be worth $125 billion in the next five years. Considering the move of the government towards fiscal consolidation the healthcare is no way a victim to the target of controlling the high fiscal deficit of our country. Public spending is likely to increase beyond 20%.  With the personal disposable income of the younger people in India increasing as they have started to work early, the demand for better quality healthcare services is bound to rise. To meet this growing demand reinventing business models that suits the new challenges and the changing generation would be better. The international organizations like WHO and UNICEF has also extended their hands in helping the industry to solve some of the growing health issues. Keeping aside the development and the negative aspects in the healthcare industry it is always wise and good to stick to healthy practices that alone will help us in long way and enjoy the fruits of this beautiful life.