Date: 17-11-18  Time: 15:59 PM

Author Topic: Cost issue  (Read 1960 times)

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Cost issue
« on: November 08, 2011, 10:32:12 PM »
Cost issue

Cost of Health Care vs Affordability for General Public

Well planned efforts are required to reduce the cost of medicines and other health care facilities.

    Abolishing the concept of free treatment. The concept of free treatment for all in a welfare state seems to be a popular voice. Once started none of our govts had the strength to revise it. This concept is impractical and has several ills. We can easily see that this system is mostly not working. In fact the concept of free medicines is one of the causes of failure and bad reputation of our govt health facilities. It is clearly not possible to provide free medicine to all the patients reporting at govt hospitals under our current economic situations.

  • Whatever medicine is provided to the govt health facilities is selectively utilized by the health authorities at their own discretion. Others are routinely asked to purchase their own medicines. This creates a sense of frustration among public who think that they are being deceived.
  • Concept of free medicine prompts those people to report sick who do not have a definite reason to do so. This puts unnecessary burden on the govt health facilities.
  • Due to limited budget the govt health facilities always remain short of staff as well as equipment. Similarly these facilities are always short of budgets to carry out necessary building and equipment maintenance. On the other hand the dependent population keeps on increasing day by day. All these factors accumulate into a poor quality and inefficient health service. This is a recipe of disaster. We have to say goodbye to it one day, the earlier we do it the better it is.

Adopting affordable treatment for all.  We must replace the concept of free treatment with that of affordable treatment for all. Let us look into its feasibility and action plan.

  • The govt will provide staff for its health facilities.
  • The govt will purchase medicines out of a specially prepared essential medicines list from the least cost bidder in open bids amongst licensed pharmaceuticals. Those medicines will be marked and labeled for govt hosp use only. The same will be provided to public on the procurement cost basis without profit. At the same time govt should establish its own production units for producing essential drugs.
  • Health facilities will charge patients a small token fee for each visit which can be set somewhere between Rs 10 & Rs 100. All the procedures whether diagnostic or therapeutic on each visit will be provided to the public on a nominal cost. The cost of each procedure would be calculated on the basis of cost of materials to the govt plus a little percentage for maintenance of equipment, while cost of trained staff will be out of govt pocket.
  • The Funds generated out of Medicines will be utilized to procure more medicines and the funds generated through procedures will be used to procure more material for procedures and maintenance of equipment.
  • The funds generated through token fee will be used to carry out the ongoing maintenance of health facilities.
  • Due to this model people with genuine reason will usually be reporting sick to govt health facilities.
  • As people will have to pay for the medicines so they will not like to stock these as bounties.
  • As govt will be eased out of its expenditures on medicines so it will be able to direct its resources in employing more staff and maintaining or upgrading structure and equipment of health facilities. This will result in better quality and efficiency of health service.
  • As this model ensures presence of medicines in govt health facilities round the clock so it will be a plus point in attracting doctors towards rural health facilities because many of the doctors have an argument that it is useless to serve in BHUs which donít have any medicines or equipment.
  • For those people who cannot afford even a token money a system of zakat should be invoked and their payments should be tackled under zakat heads.
  • Similarly Emergency cases will not be charged any amount beforehand. They can be put into the categories of affording or zakat afterwards.
  • This is a technically feasible and highly practical model as compared to the existing one. In the existing model we have assigned impractical goals to the health care system as we are not giving them the required budget to meet the goals. The reason of failure in our current system is basically more related to unrealistic health policy rather than the corruption or mismanagement of health care givers. The currently proposed system ensures realistic tasks and availability of proper resources, so only honest and dedicated implication is required.