G Sampath: No country for sick men

Whenever I fall ill, I first visit a gynaecologist. Although I don't possess the body parts that might make her professionally appropriate for me, in this vast city of 20 million, she is the only qualified allopathic doctor that I can trust.

Not that all other doctors in the city are untrustworthy — but this doctor, my wife's gynaecologist, is the only one who doesn't make me feel like a wallet with a body attached.

Why has it become so difficult to find a doctor one can trust? Earlier, when I was growing up, my parents' anxiety would be about finding a 'good doctor', someone competent. But today there are enough doctors who are as competent as the best in the world. But sadly, they don't see a patient walk in — they only see a revenue source.

I haven't conducted a poll. I speak from anecdotal evidence and recurrent personal experience when I say that, today, putting profit over patient has irrevocably corroded the bond of trust that ought to be the basis of every patient-doctor interaction.

Some years ago, a reputed urologist made me go through a surgery that later turned out to be unnecessary. Actually, he was the third 'specialist' I had consulted after the first two, who I suspected of being infected by the profit bug, couldn't come up with an effective treatment even after making me take innumerable tests involving every possible bodily fluid save my tears.

Thanks to this needless surgery, I suffered twice over — the severe post-operative physical pain it caused me, and the mental, emotional and financial pain I went through because the reputed health insurance company refused to reimburse the costs, stating that the surgery was unnecessary, which it was. But is it the patient (or patient alone) who should be victimised for going through an unnecessary surgery? After all, which patient would want to be operated upon just for the pleasure — or pain — of it? (I admit I have masochistic tendencies, but I'm sure they are not medical in nature.)

Instances like these have convinced me that public health cannot be at the mercy of private profit. This urologist was obviously getting compensated on the basis of the number of surgeries and tests that he generates for his hospital. And same is the case with thousands of doctors, private clinics and hospitals. Similarly, the very revenue model of health insurance companies is based on how many claims they can reject, and get away with. The guiding principle of our healthcare system is simple: the patient's pocket is more important than the patient.

In this scenario, the human element — the suffering patient — takes a backseat, as doctors and hospitals hurry past him to reach their revenue targets.

And I am talking here only of healthcare accessible (sort of) to the middle class — the private clinics and hospitals. What about medical care for the poor? To call it pathetic would be an understatement. But that's
another story.

So, the only people who can afford proper medical care in this country are the wealthy — who can shell out enough to take a second or fourth opinion on a single ailment, and do the barrage of tests (both needed and not needed) without feeling the pinch financially.

Strangely enough, while our government spending on health, as a percentage of GDP, is one of the lowest in the world (it is not even 1%, in case you were wondering), our spending on internal security and the so-called war on terror is ballooning up.

Sure, it is all very well to splurge on drones and bombers, but what about security from disease? What about the terror of being unable to afford treatment for an illness? Lot more Indians fall prey to terrorist attacks from a virus or bacteria than to terrorist bombings. But neither the government nor the media respond to those deaths with the same degree of seriousness.

Everyone knows that the bulk of healthcare spending in India happens in the private sector. And I've pondered over what it says about our society. I think this is what it says: only those Indians who can afford to pay deserve to live; if you are too poor to pay for treatment, go and die somewhere. It's hard to accept that this is the kind of 'superpower India' our freedom fighters fought for.