Recently when I called my 70 year old mother who lives in a small village in Palakkad, Kerala, she said, “I’m off to see the Doctor. Wish me luck.” A day later, I called her again and asked how the consultation went. She was fuming and irritated. Apparently, she was kept waiting in a small room of the private clinic for over for hours along with a dozen other patients. In the intervening time, the doctor was busy meeting several medical representatives who were given free access by the receptionist. My mother crossed off her name from the waiting list and left in utter dismay.
The cosy relationship between doctors and prescription drug companies has long made Indians nauseous. It is evident that there is a nexus between physicians and industry. These days, doctors not only get money from drug companies but all-paid holiday junkets, white goods as gift and from school donations to university tuition fee paid for their children.
Health as wealth
A German television channel cited the reality where millions in India have simply stopped seeking medical help for their ailments. Why? Simply because either they cannot afford it or they are too terrified to seek medical counsel.
Merchants of death
One of the European dailies reported of the callous attitude of doctors and nurses at general hospitals and primary health centres in India.
The news item depicted the correlation between lack of essential medical equipment and genuine drugs and the rising incidence of patients’ mortality in India. From what I know of their training and the Hippocratic Oath, medical doctors are expected to be caring, loving and sympathetic towards their patients.
Unfortunately, what we have in India is mostly the repulsive, dreadful reverse of what ought to be. The problem pervades both the private and public health institutions. Mostly, private hospitals are run as profit-seeking business concerns. The billing department is the most active in these morbid institutions.
As for our general public hospitals, it is a laid-back, apathetic and indifferent attitude which has wreaked havoc on our public health service. Often, right from the time needy, helpless patients seek to obtain a card they see hostility staring in their face from the nurse or administrative staff attending to them. The situation will only be different if the patient is a friend, related to them, or displays wealth.
I recall the incident where the wife of a German diplomat friend in New Delhi who was pregnant preferred to return to Germany as she was constantly coerced into undergoing surgery-assisted delivery owing to the selfish motives of the doctor. In emergency cases, our doctors insist that unless a patient (usually in coma or close to death) and his relations make a deposit, no medical treatment will be given him. Yet, when the same patient dies due to denial of timely medical attention, his saddened relatives are asked to pay a huge amount to release the body. This is rampant in private hospitals.
Health care in Europe
In much of the Continent, healthcare is run with, to use a German clich©, “German thoroughness and perfection”. Most European citizens are, by and large, quite happy with the system. Everyone in Germany, France, Austria, Nordic, Benelux countries and Switzerland has health coverage – It’s required by law, with the government providing generous subsidies for those who couldn’t otherwise afford it. And, unlike in Britain and Canada, there are no long waiting lists to get elective surgery or, see a specialist doctor.
Europe offers affordable healthcare that is easy to access and painless to use. Medications are provided free or at a deep discount by the national health insurance system. National insurance also reimburses 80 per cent of the cost of a visit to a doctor. The rest gets picked up by supplemental insurance, which can be purchased for a small monthly fee. Most Europeans have supplemental insurance, and it’s often paid in full or, in part by one’s employer.
Not long ago, the Paris-based Organisation for Economic Cooperation and Development (OECD) surmised that 75 per cent of the world’s total supply of fake drugs can be traced to India.
Undoubtedly, the main cause of the problem lies in our own country and the callous nature of regulatory authorities. To counter this, the WHO established the International Medical Products Anti-Counterfeiting Taskforce (IMPACT) in 2006. In Europe, counterfeiting drugs is treated as a serious crime and punished severely. Within Europe, a drug’s journey from manufacture to sale is scrutinized carefully.
There are also anti-counterfeit marking on packing – in particular a barcode, holograms and seal, to show clearly if a package is genuine or has been opened. Also, Europe has very tight controls on suppliers.