Let taxpayers pay for ‘our’ treatment abroad – And let them rot in Government Hospitals

The Government of India has recently gifted itself a privilege. The state will reimburse the total cost of medical treatment for the three highest civil services officers (yes the IAS, IPS and IFS). And this entitlement is not limited to procedures that cannot be carried out in India. As this newspaper reports , these officers can decide to go abroad for even now routine procedures such as bypass surgeries. A privilege that is rather unfair, undemocratic and borders on institutionalized corruption. Here’s why.

First, the most obvious argument pointed out in the newspaper article itself, is the huge expenditure to the exchequer. However that to me is the beginning of why this is problematic. The following two concerns are perhaps more grave.

The first argument is that such an entitlement cannot be limited to the officers of the three Elite services.  Let me explain. India has a socialist public health system. In other words, our public hospitals treat every citizen according to their income. The poor are charged the least and so on. (Certain government jobs entitle all employees to treatment at government expenses). The network consists of primary health centers, district and state hospitals and more specialized referral hospitals  such as the All India Institute of Medical Sciences (AIIMS) at New Delhi. Every patient irrespective of social or economic status can be referred upto AIIMS for treatment. So if treatment abroad has to be on government expense, why should it not extend to all beneficiaries of the Public Health system? Should it be based on your status in the government or on the complexity of your illness?  Readers familiar with Animal Farm may remember what the pigs did for themselves.

The second argument is that such policies will only lead to further degradation of the Public Health Infrastructure. I recently had written about how a state hospital was unable to treat a case of hydrocephalus, a rather common condition among infants and elderly. The IAS run our health ministry and hence ensure the functioning of this system. If they are allowed to avoid and escape the system for their own use, they will never empathize with the concerns of the infirm common man. An analogy can be found in public transport. India’s public transport is pathetic because those who oversee its smooth functioning are not its users. They ride chauffeur driven cars, which contribute to their apathy at the plight of those who ride trains and buses. Likewise for primary education and the state of government run schools.

This law needs to be immediately challenged in the courts. Beyond the most direct arguments of an expenditure the government should not incur, there are other grave concerns.

Such policies are based on flawed principles! I am willing to work with any individual or organization that wants to file a PIL, organize a protest and represent against this decision. Please email me/ comment here and I will be all ears.

India’s Public Health System Fails Yet Again: The case of Runa Begum with Hydrocephalus

You have already seen the news about Runa Begum, a 17 month old baby girl from Agartala, Tripuara who suffers from Hydrocephalus, medical condition in which fluid accumulates in the brain leading to an abnormally large head circumference. It is reportedly a serious but largely correctable medical condition.  The short story is that Runa, was born with this condition and only after recently her story along with pictures, circulated globally via media and online social networks, now she is being treated at an elite private hospital in  Delhi, some 2000 kms from her hometown. This has been made possible only by private charity. However, cases such as these raise several questions on the state of our public health system.

Given that her head has swelled to 3 times the normal size, presumably the condition manifested at birth or even before. So why did it take 17 months of worsening complications and media reports for the family to receive medical attention? And that too by the private sector and/or charity.

News reports say that the family was denied treatment at the Government Medical College at Tripura as they could not produce documentation that they were ultra poor and such a surgery costs a lot of money. Moreover a ‘rare’ condition such as this required advanced medical care that was perhaps beyond the expertise of  the Agartala hospital.

First, hydrocephalus although uncommon, is not really a rare disease as it affects 1 in 500 children born. Second, Agartala is not a village but the largest city in one of  India’s 28 states. The Government medical college at Agartala there has a multi specialty hospital with clinics in Pediatrics  Surgery and Neurology, all three specialties required for such a case. Moreover they are linked to many other hospitals through telemedicine, precisely to seek consultation on cases they are unable to handle.  Despite all this neither were they able to treat a child with a potentially fatal condition for 17 months nor arrange treatment elsewhere? They merely let fluid accumulate in her head, which has now swelled to 90 cm, much larger than what is usually documented for this condition ( Images revealed by web search show much smaller heads)

Thankfully for Ranu, the visually stunning nature of hydrocephalus , caught the media’s eye and subsequent support poured in. However there may be thousands other less fortunate poor kids whose parents may not have documents to claim abject poverty, yet may be poor enough to not be able to afford any private hospital.

While we hope for Ranu’s recovery. the minimum I demand from the Health Ministry is to conduct an inquiry into why exactly was this case not treated by the hospital, which claims its vision as “To provide best Health Care facilities to the people of North-Eastern Region”!