We are a country of sick people. Are you aware that 32 per cent of Indians die before the age of 14? Or, that there is only one hospital bed per 1,000 people as against the World Health Organisation norm of 3.2?
We simply don't have enough hospitals in the country for the large and growing number of people with health problems. Of the ones we have, most are in miserable state.
Although the Tenth Plan document has projected a 62 per cent hike in health budgets, it appears that the situation is unlikely to improve much in the near future.
Even the Plan document has hinted at this by proposing a shift from merely allocating resources to the sector to focus on policy, procedural and institutional changes that are essential to improve the existing services in the country.
This involves a greater role for the private sector in terms of operationalising public-private partnerships.
In fact, the role and involvement of the private sector will be crucial if India has to achieve the WHO norms. But attracting private investments in the health sector is easier said than done.
For, to most of us, a hospital or a clinic, unlike any other enterprise, epitomises a facility with nothing more than an unfailing sense of social responsibility -- meant only for not-for-profit, charitable purposes.
It is, perhaps, because of the prevalence of such a not-so-healthy social psyche that the corporate presence in the sector is almost negligible.
Except for a couple of relatively new entrants, all we have are trust hospitals, government-owned facilities or physician-promoted nursing homes.
In the absence of a regulatory mechanism and, also, competitive forces, the standard of healthcare delivery in most of these facilities, as we know, is not very satisfactory.
The lack of a professional, business-like approach has also meant that a large number of these facilities are financially sick. In fact, for a long time, the prospect of a hospital project meant nothing more than trauma to financial institutions who fund such projects. The story doesn't end here.
What's equally alarming is the belief that hospitals, by definition, cannot make money. As a consequence of improper planning, a large number of hospitals in India take years to get completed, and hence, find themselves in a perpetual interest burden trap, thus reinforcing such a belief.
Fortunately, the scenario seems to be changing. Lately, leading corporate houses have made significant investments in the healthcare infrastructure sector.
Michael K Jhin, president and CEO of the 595-bed St Luke's Episcopal Hospital in Houston (which houses the world-renowned Texas Heart Institute) says, "This is one discipline, which allows you to do well. And do good."
There is a lesson to be learnt from organisations like the Housing Development Finance Corporation. With a clear commitment towards facilitating housing for millions of needy Indians, it seems to have perfected the art of doing good, and doing well.
In this country, where there is such an acute dearth of hospitals, a well-planned and well-run hospital will always offer favourable returns.
The 300-plus-bed Hinduja Hospital in Mumbai, which is one of the few well-managed trust hospitals in the country, generates more surplus, despite a fair amount of subsidy, than the 310-bed Hotel President in the same city.
Moreover, it doesn't have to contend with the vagaries of the travel industry or the inevitable business cycles.
What's more important is the fact that an efficient, organised and thriving private business will ensure that hospital services become more accessible to the lower- and middle-class sections.
While this may sound improbable, it is actually true. In the mid-1990s, getting a bypass surgery was really expensive. And most patients had to go abroad for the operation.
But, after the mushrooming of world-class private heart hospitals, prices have crashed and same surgery can be conducted at one-tenth the price. More importantly, more people can afford these prices.
At the same time, a thriving private business enables medical insurance firms to expand their services. The insurance firms need an adequate, credible safeguard against frauds -- and the organised private enterprises provide that.
Large hospital chains also rope in institutional, corporate clients who, in turn, tie up with insurance firms to provide adequate health cover to their employees. That, too, leads to more people getting access to private services without having to cough up the money from their pockets.
For all this to happen, we need to first cure the misconceptions, we need to accept that a hospital can make profits. And, equally importantly, it should. A healthy attitude towards the healthcare industry, to my mind, is the first step to a healthy nation.
The author is CEO of Apollo Health and Lifestyle Limited, a subsidiary of the Apollo Hospitals Group. Views expressed here are personal.
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