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Social Justice Through Health Care

admin — Sat, 04 Sep 2010 20:49:07 +0000

SOCIAL JUSTICE THROUGH HEALTH CARE

We hardly come across a person who may be fully satisfied with the health care delivery system run by either the government or the private sector. This is true not only for developing but for all the developed countries as well. Every law abiding, contributing individual has some legitimate expectations from the state. Disenchantment with present dispensation of health care compels people to seek better options across the borders. Even the present flow rate of patients from developed to developing countries has assumed the proportions of Medical tourism. Medical tourism is not a one-way traffic. Poor from India are known to visit Rashid Hospital at Lahore for kidney transplants. Medical tourism will definitely bring in world class equipment and services in our corporate hospitals. These corporate tertiary care hospitals can act as excellent referral hospitals. Lack of enough clinical material, as the patients are often referred to in medical parleyences is prompting the doctors from developed world into medical adventurism. Very recently two NGO’s headed by renowned plastic surgeons of Indian origin were in India, claiming to their credit hundreds of cleft lip and palate surgeries conducted in one week. During my brief interaction when I asked them one basic question that how do you justify single step surgery by a single specialist for a clinical entity that require 3-5 set up surgeries by 10 specialists over a period of 20 years, there was no answer. On record local doctors conduct all these surgeries. These NGO’s bring in a battery of trainee resident doctors for hands on training. Dumping of questionable services and drugs continues unabated in the absence of stringent regulations. Clear-cut up to date guidelines by health authorities have yet to be issued to safe guard the health interests of this nation. Most of the drugs banned in developed countries are still being dumped in the Indian market. Commerce alone dictates the policies of multinational companies in health sector of developing countries. State and national medical councils, the watch dogs of our national health interests are controlled by elected representatives from among the doctors. Competitive populism for being elected to these high offices takes away the very sting off these regulators. In this ‘market forces’ driven health sector, apart from other factors, size of the population, economic prosperity and literacy levels dictate the out look of key players. Subjective as well as objective assessments of the health care operations leave people confused with huge piles of data and endless interpretations. At the tail end of govt. health care delivery system is the rural dispensary or the slum revamping center, and the end user an illiterate or semi literate villager or a slum dweller. Dispensary is the humane face, the welfare state can present to its people. In yesteryears the service providers were from among the same social class they used to serve. Doctor can be a friend, philosopher and guide to the locals. Unfortunately the economic and social disparity between the service providing doctors and the service user population has grown enormously. Ad-hocism in health care delivery should be done away with immediate effect. Doctors and paramedical staff appointed on yearly contract basis are not showing any interest in the national programmes. Established private health care providers also have not shown any meaningful commitment for national programmes. Middle class itself has fragmented. Now it is fashionable to assign economic values to any issue like gender, but for social responsibility and justice. In this era of fast paced growth, the unorganized, silently suffering millions can not be wished away. Once reading on biodiversity I stumbled upon a very interesting quote, “only the species with economic importance will survive”. In our active pursuit for magnetizing economy, we assigned economic values to any thing except for morals. Commercialization of education has produced a new breed of professionals who have scant regard for professional ethics. Privatization is the buzzword with governments, because it takes away government responsibility. Private sector players are eyeing many ‘viable’ health institutions. There are no takers for commercially non-viable rural institutions. Rural health institutions dispense social medicine. Very recently one of the key players from private sector health care quoted the cost of developing one bed in corporate hospital at Rs. 30-60 lacs. These corporate health services are definitely out of each of the common man. These type of hospitals are definitely required for a nation with the present rate of growth but ‘bharat’ definitely needs different kind of hospitals. There are very strong social under currents against the exploitive private healthcare, inadequate government sector health care resources and the indifferent approach of welfare state. Health for all is a very lofty but expensive proposition. There are ways and means to reduce the pressure from government institutions. Private-public partnership, health insurance, monitoring and regulation of private sector health care can all make the things bit easy. Preventive health care education can go a long way in improving the public health. Community participation in health care has produced few but wonderful examples. Complementary community participation can make up for minor but critical deficiencies in the government run health care system. Setting up of health system corporations with World Bank assistance has already improved the working of govt. sector health care institutions considerably. Community participation through NGO’s can still improve the system, but most of the meaningful NGO’s turn their back on govt. run health care institutions because of their doubts on the integrity of government officers. Government health care institution are increasingly seen not as caring hospitals but like police stations, where medico legal reports are written and postmortems conducted. Most of the government doctors’ time is spent in courts appearing as medico legal experts witnesses. Emergency, post mortem, and then the VIP duties in addition hardly leave the doctors free for any meaningful job at government hospitals. There is an urgent need to have separate curative, preventive, legal, administrate and health intelligence wings. Government hospitals attract the poorest of the poor, mostly people from the unorganized sector. Their contribution to national GDP is by no means small. With the present growth rate, upward social mobility is seen in every strata of society. Many segments of this unorganized sector can be organised so that they also enjoy the patronage of welfare state in the form of health insurance policies. Apart from direct benefit to these segments of society, the state will benefit from the ‘off loading’ of burden from government run health care system and loading it on insurance driven private sector health care institutions. Poorest of the poor will repose faith in welfare state. Sanjivini, health insurance policy with the Punjab Milkmen Cooperative Societies is already a big success. ECHS (Ex servicemen Contributory Health Scheme) is an other success story. These success stories can be replicated with countless groups like, panwallas, dhabewallas, autorikshaw drivers etc. Simply organize the unorganized sector. There is no dearth of role models from among government doctors also. Their inclusion rather than drift after dissent from the present dispensation of health care will immensely improve the system. Stability of tenure is an excellent incentive government can give to its doctors without costing anything to exchequer. Yet tenure beyond decades should be discouraged as it leads to development of vested interests of the old incumbents and denial of chance to the youngsters. Resource mismatching is a major problem in the govt. run health care system. There are dispensaries where specialists are posted and still many more civil hospitals where non-specialist are posted. These
mismatching result in defective and inefficient health care. Nodal Hospitals can be created for round the clock emergency services by cannibalizing defunct and sick institutions where equipment worth crores is lying unused and salary bills are bleeding the exchequer white. Most of the medical officers retire in the same administrate rank. This undue stagnation has forced many a brilliant doctors out of service. By simply seeking options for place of posting, honestly implementing with minimum displacement on merit can also revitalize the govt. doctors’ cadres. Private sector health care delivery system is a totally market driven commercial enterprise. So called ‘market forces’ have least respect for ethical and moral value systems. Multi level marketing chains have evolved in the name of referral systems. End result is exploitation of the unsuspecting common man, who still regards his healer a holy person. This ‘incentive’ system is strengthening the hold of unqualified, unscrupulous and unregistered medical practitioners on illiterate masses. Not many qualified doctors are unscrupulous. A large section of private health care providers feel genuinely threatened by blackmailers of all sorts. Consumer protection act is a very convenient beating stick in the hands of their tormentors.

Under the constant threat of being blackmailed, the private health care providers are becoming more defensive in attitude. More patients are being referred to tertiary care institutions for this reason only, thereby flooding the referral institutions. People have a common feeling that sickness is an invitation for exploitation at the hands of private health care providers. Even the charitable hospitals are charging as heavily as fully private hospitals. Medical profession is fully responsible and capable of self-correction. Medical councils and associations can jointly evolve a fail-safe mechanism to keep their black sheep under check even without government help, but the buck stops with the government. Welfare state is duty bound not only in providing health care delivery system but also proper health care administration and social justice through its health care delivery mechanism.

Name : Dr. Pardeep Kumar Sharma

Email-ID : omfspardeep@yahoo.com.

(M) : 0988456296

Date of Birth : 12.02.1962

Education Qualifications : BDS (Bachelor of Dental Surgery)

MDS (Master of Dental Surgery in Oral and Maxillofacial Surgery)

Educational Institutes Attended

Govt. High School Bargari : Matriculation (1969-1977)

Distt. Faridkot, Punjab, India

DAV College Chandigarh : Pre-University (1973-79)

(Punjab University)

Barjindra College Faridkot : Pre-Medical (1980)

Dental Wing, Medical College : BDS (1981-1986)

Patiala

Dental College and Hospital : MDS (2003-2006)

Amritsar

Professional Experience

House Officer, Christian : 1987-1988

Medical College & Hospital,

Ludhiana

Research Officer, All India : Jan. 1989 to June 1989

Institute of Medical Science

AIIIMS, New Delhi

Dental Officer, Indian Armed : July 1989 to August 1994.

Forces in the Rank of Capt.

3

Medical Officer (Dental) : w.e.f. Nov. 1995 till date

in Punjab Civil Medical Service

(PCMS)

Research papers Published

“Role of Programmed cell death in dental anomalies associated with cleft lip and Palate”. “Medical Hypotheses” Churchil Living Stone Publishers London-1991

Post traumatic polatoglossal adhesion, a case report stomatologica India (1990).

Research Project Undertakes

“Malocclusion and associated Factors among Delhi Children” a study sponsored by Indian Council of Medical Research (ICMR).

Areas of Interest : Environment, Health, Defence, International Affairs and Rationalism

Do You Need to Obtain a College Health Care Plan?

admin — Fri, 30 Jul 2010 13:11:21 +0000

Upon graduation from high school, there is no doubt that you will surely start your tertiary education in college or university. At age twenty, children will not be covered by health insurance of their parents and this can be disastrous if they are merely study and do not do part-time job. Some universities or colleges may have insurance plan offered to students. These insurance may not answer all your needs but you need to be meticulously considered it.

Most of the universities and colleges offer student health insurance plans. These plans should absolutely be at reasonable price, and can give you the school’s nearest hospitals. This option is one that you should definitely think of, if your son or daughter is enrolled in a college far away from home.

College health care scheme may vary from college to college due to laws and some other factors. Many students may think medical services are free of charge, but it is not always true. In term of clinic visit or routine checkups they may be free, however students still require to pay for special kinds of lab tests and other specialties such as x-rays, prescriptions, and a wound treatment. Compensation usually covers some types of service stated in the health care offered at college health centre. When you are referred to see an outside doctor, then the coverage will cover only 70% of your total expense and you are at risk to pay high medical cost.

You may have a problem getting treatment at the campus health centre if you have pre-existing condition. Having a pre-existing condition or illness does not mean to prevent you from obtaining health insurance plan, but you may not be eligible to have your treatment on your pre-existing condition. It can be troublesome if your new symptoms develop from a pre-existing one.

Health schemes are different, so be sure you find out everything about your health insurance plans. Be sure that your health plan stretch to summer break when you or your child do not take classes. This is vital for you because you don’t want to find out that your health care does not cover when you need it most. Some college health insurances may not cover during summer break, while others do.

Be certain that you study your plan thoroughly. Is it an HMO, or can the member utilise any service provider they went? This is critical. You need to know where you can go in case of emergency, and there is nothing worse than discovering that you will have to pay off the bill yourself.

There is no definitive solution to whether you should or should not commit yourself to college health insurance. Be certain that you study your plan thoroughly so that it answer to your need when you need it most. Although there is no free health insurance scheme, surely it will save you a lot of money in time of illness or accident.

For more information, please visit http://www.health-care-central.com

Simple Steps That Employers Should Practice to Increase Their Value of the Health Care System

admin — Sat, 17 Jul 2010 17:30:31 +0000

ited States, there are a lot of employers who see health care benefits as the enemy. This is due to the fact that some health care providers fix their attention on the growing cost of the services that are included in the health care package, and this has led them to take steps to lower the rates. Most countries have put this subject on the sideline and they expect that the government will take care of the issue. Some of these health care providers hope that the insurance companies of the patients, or the government will take on this responsibility.

One thing that employers fail to understand is that no matter how hard they try to avoid the subject of health care issues, it will forever haunt them, no matter what kind of health care system is being implemented. The responsibilities of these health care insurance companies include the liability of paying the medical costs, absenteeism, and any other health related issues that they have to pay due to poor health.

According to one study in the United States, most employers use up millions of dollars paying for the indirect expenditure due to unfortunate health condition rather than spending their dollars in health benefits. The expenses that the employers have to pay when it comes to poor health are significantly higher. Conditions like diabetes, heart conditions, and respiratory troubles are among those medical conditions that can cost an employer a fortune, and getting out of this situation will not solve the problems of these health care providers because it will continue.

Most European countries have discovered that investing in the health of their employers by providing them with wellness programs will significantly increase the productivity of their employers, thus decreasing the amount of money that they have to pay for the cost of poor health. One of the approaches that the employers use is bargaining for the best and maximum amount of discounts that they can get from other health plans providers and third party health proprietors. Often they are constantly searching for companies that can help them to provide better deals for their employers. This action on the part of the employers can cause confusion among their employees.

Due to the increase of health care costs, some employers have passed on their responsibility of paying the cost of the health care to their employees. Many of the steps that these employers take as far as health care issues are concerned has cost them more. So, one vital thing that any employer can do to improve their health care system is to consider the value of the health care services and not just the cost alone. After all, it is the results that both employers and employees are after. The main objective of this approach is to increase the value of the services and not to reduce the costs of the overall health care benefits.