Thursday, July 3, 2008

Poverty and Medicine

Being a doctor you come in touch with the economically weaker sections day in and day out. When ever you write a prescription or order a test you have to keep in mind the financial status of the patient.
In India very few have health insurance. The very poor go to the Government run Hospitals and clinic. Those who can afford to spend some money from their pocket go to privately owned Hospitals and clinics. But many times the poor may have to go to private Institutions as the Govt Hospitals may not be accessible or the one near to their home may not be adequately equipped to deal with their problem.
So the treatment that is given in private Hospitals [like where I work] differ according the monitory status.Intensive care, frequent blood monitoring,expensive imaging tests like MRI etc may be offered but not insisted upon in case of poor patients.We doctors try to diagnose using all our experience and many a time rely on empirical therapy[ie presuming the diagnosis and treating].The drugs prescribed will not be the newest and expensive ones. Even among poor patients there is discrimination.Families tend to spend less for older people. Many a time they discharge and take home the old before complete recovery. Ventilators and other life saving equipments will be switched off on request.
Though it is expensive many poor people like to get treatment from private Hospitals.One of the major reason is lack of dignity and personal care in Govt Institutions.Over crowding and lack of funding is the cause for this undignified treatment for patients. Severe shortage of infrastructure,staff,equipments etc make the matters worse.
Is Health Insurance for All the solution?


CALpumper said...

You ask a tough question Doc.

I think each country asks this.
But not every country wants it.

While most citizens do, many realize it may not be the answer.

It would be nice but not necessarily good for the country's economy as a whole. Each country is different, as are its citizens.

Sometimes looking/digging deeper is where to start. Why medical costs are so high. For the appt itself, for labs, for equipment etc etc. Maybe starting there, lowering the cost of giving medical attention is the question....

Just a different perspective to consider.

charakan said...

Ideally the State should support the sick and poor. Insurance companies with thier major interest in protecting the profit margins will never do it.But will such a huge State spending be economically viable? I do not know