First Published: 20:09 IST(27/5/2012)Last Updated: 20:23 IST(27/5/2012) I am a bit of a dreamer. And that’s one of the reasons I am able to do this show. I dream that one day wewil be living in a country where things wil be different. I dream that one day, in our country, the rich and thepoor wil both get the same good quality healthcare. To many it may seem like a totaly impractical, and anunachievable dream… but it’s a dream worth dreaming… and one that has every reason to come true.
Irrespective of whether you are rich or poor, when you lose a loved one, the pain is the same. To watch mychild suffer and die while I am unable to do anything because of an incurable disease is truly sad.
But, if there is treatment available which can save my child, but I am unable to save my child because I can’tafford it, and can only helplessly sit by and watch my child die… that is unimaginably tragic.
What is stopping us from having a great public healthcare system? A number of us pay our taxes. Some of us don’t. And most of us don’t earn enough to be required to paydirect taxes. Then, there are indirect taxes. A host of indirect taxes are also colected by the State. Each timewe buy something — salt, sugar, tea, anything — we pay some tax or the other. So, it turns out, that the poorare after al paying for public healthcare too. Only they don’t get proper healthcare services in return. Lessthan 2% of our Gross Domestic Product (GDP) — 1.4% to be precise — is alotted to public healthcare.
Dr Gulati, one of the guests on our show, and someone who has been working in this area for years, said,that it should be at least 6% for a very basic level of public health facilities. I am neither an economist nor adoctor, but I would prefer to err on the safer side and say 8% to 10% is what it should be.
What is the point of having a great GDP if as a society we are not healthy? Economic strength wil come onlyif we are healthy, and it wil be of some use only if we are healthy enough to enjoy it.
Importantly, health is also a state issue and each state colects only indirect taxes. Why isn’t more of ourmoney spent on making more public hospitals, and more importantly, on public medical coleges? Why arethere not enough public medical coleges with attached public hospitals across each state? With a vibrant young population, more public medical coleges is the need of the hour. But it seems thegovernment at the Centre, and al the state governments, are concentrating less on opening governmentmedical coleges. Therefore, the great need of young students wanting to become doctors is getting filedby… you guessed right… private medical coleges, many of who I am told charge Rs 50 to Rs 60 lakh asunofficial donation.
In most cases, private medical coleges are springing up as businesses. Many of them don’t even have properrunning hospitals attached to them, which is mandatory. I sometimes wonder about the competence of the doctors coming out of many of these private medical coleges.
We need to insist to our state governments, and the central government, that we want more public hospitalswith attached public medical coleges. Private hospitals are most welcome, but let’s concentrate on our publichealthcare system and make it so strong that private hospitals have to work harder to compete, and,therefore, we as a society get better healthcare services.
When a student sits for his/her MBBS exams and is asked to name the drug that is to be prescribed for apatient suffering from diabetes, he might write ‘glimeperide’. This is the salt commonly used to treat diabetes.
When that same student becomes a doctor and a patient suffering from diabetes comes to him for treatment,he might prescribe the medicine Amaryl. So is that young doctor giving the wrong medication? No. Amarylhappens to be one of the brand names by which the salt ‘glimeperide’ is sold. So what is the differencebetween the two, apart from the names? Wel, a strip of 10 tablets of Amaryl costs around Rs 125, and astrip of 10 tablets of the salt ‘glimeperide’ costs Rs 2. Both are essentialy the same thing. We payapproximately Rs 123 more for the brand name.
The common cold is one of the most prevalent ilnesses. The salt name of the medicine used to tackle thecommon cold is ‘cetrizine’. Now, the manufacturing, packaging, transportation costs of this generic medicine,including a decent margin, is Rs 1.20 for 10 tablets. But the branded version of the same medicine, forexample Cetzine, costs over Rs 35 for 10 tablets.
A common injection used to treat blockages that cause heart attacks is ‘streptokinase’ or ‘urokinase’. Theseinjections cost Rs 1,000; in their branded form they cost over Rs 5,000 in the market.
Malaria is a big kiler in India especialy among children. A critical injection that is used to treat resistantmalaria is available at, as little as, R25 for a pack of three injections. However, the branded versions of thesame injection costs Rs 300 to Rs 400.
In cases of diarrhoea, another big kiler of children in India, the vomiting that causes dehydration can bestopped with a medicine whose salt name is ‘domperidone’, which is available at Rs 1.25 for a strip of 10tablets. The same medicine in its branded version Domstal sels at Rs 33.
How can our poor, or for that matter even our middle class, afford medication? In this regard, we have to applaud the efforts of the Rajasthan government. It has set up shops seling genericmedicines across the state in an effort to make good quality medicines available to people at the lowestpossible rates.
Roughly 25% of al the ailments go untreated in India because of financial reasons: think of the differencegeneric medicines can make to every Indian. If the Rajasthan government can do it, why can’t other stategovernments do the same? One interesting piece of information: the ministry of chemicals and fertilizers offers Rs 50,000 to anyonewanting to open a shop seling generic medicines, and at their discretion they also sometimes offer space toopen such a shop. Looks like my dream of good quality public healthcare being available to rich and pooralike may be possible after al. PS: Can our doctors please write out the generic name of the medication when they write out ourprescription, and alow us to choose the brand. or not.
Jai Hind. Satyamev Jayate.
Aamir Khan’s column will appear every Monday The views expressed by the author are personal Copyright 2012 HT Media Limited. Al Rights Reserved.


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