Corporatisation of healthcare: Weighing the pros and cons

The healthcare industry in the past has majorly been under the control of the government, however, in the recent past a number of private companies have marched in to become medical service providers. This has led to a trail of changes and modification in the Indian healthcare sector – commercialisation being the current trend.

Commercialisation is a subjective term and every organisation has a different approach and way of practising it. The responsibility to provide supreme healthcare services majorly falls on the shoulders of the government, the responsiveness of the governments towards providing basic, general healthcare facilities leads to public satisfaction. Over the years, the private sector has come forward and contributed in healthcare in a major way and has brought about several changes in the medical industry. Today, healthcare has become an acquired service, and for a few it has become inaccessible due to the high cost. Commercialisation has come in with a bang with its advantages and disadvantages, and is definitely here to stay.

“It is not possible for the government to fulfill all the requirements of the healthcare sector in India due to its huge population. Due to this a huge demand-supply gap in healthcare was emerging and to bridge the same a number of private players entered this sector. This is a socially relevant sector and involvement of more people in terms of investing is a welcome change. For the private players, healthcare has become a form of business and as they are investing capital it is right for them to expect a reasonable return from this business. In the urge to create profits, commercialisation has taken place, which has impacted the industry in many ways,” believes Ratan Jalan, Founder & Principal Consultant, Medium Healthcare Consulting, Bengaluru.

Pros

Dr Jairam

Great alterations have taken place in the healthcare sector after commercialisation has taken over. The biggest advantage is that today a number of hospitals are present not just in the cities but have also entered the rural parts of India and are striving to provide quality medical services. This change has taken place due to the rise in competition. Healthcare industry is a very sensitive area and is a byproduct of what we do. It is the service that comes in first and therefore the extent to which it is taken up by the citizenry is more important. Commercialisation brings continual improvement of service quality and makes it popular with the citizenry. It helps increase healthy competition and be better than the best and break benchmarks and improve on the services provided and is also helping hospitals and other service providers come together and provide better and affordable services to primary as well as secondary sectors,” says Dr Debarshish Sharma, Head Medical Servies, Fortis – Anandpur.

Commercialisation has also helped the Indian medical sector take a huge leap towards growth by offering a wide range of medical care and facilities. High-end technologies to assess the patients’ total health condition, advanced technology for surgerical practices have all come in due to the private sector. Commercialisation largely means privatisation that offers best quality in health care. Better services, quality maintenance, high standards in services are the positive sides which support commercialisation. According to Jalan, “There is a huge demand-supply gap and it is important that the private sector plays a key role, which I feel is already happening as it cannot be just left on the government and is a welcomed change. There is a certain amount of competition that is happening due to commercialisation which helps but my fear is if there was lesser competition, the cost would have been higher, because of competition there is some pressure that is created on hospitals for costing which helps keep the cost of treatment as well as consultation under check.” He added, “Commercialisation leads to greater investment, more facility, greater employment, better quality, greater delivery and competition. Today, a number of hospitals are entering the rural sector, which has made availability and accessibility of healthcare very prominent. So it is definitely a good change, as it is a socially relevant sector, it is due to the commercialisation that better quality, availability and pricing is experienced in the market.”

Cons

Jalan

“For me, commercialisation means exploitation of people by over charging them for the services rendered. One has to differentiate between commercialisation and corporate medicine.” He continues, “Corporate healthcare is healthcare that is delivered by private players where care is delivered at value for money, this is not commercialisation. Exploiting people by unethical practice or overpricing is commercialisation for me, which is what has been taking place unfortunately.” He adds, “People attempt to make quick money but fail to understand that this sector requires the highest level of ethics and integrity and if they do not live up to it, then it should be condemned and be strongly dealt with. Bodies like the Medical Council of India need to take a straight forward role for this to ensure transparence and eradicate exploitation,” avers Dr Nandakumar Jairam, Chairman and Group Medical Director, Columbia Asia Hospitals India.

Another disadvantage of commercialisation is the lack of transparency and the increasing costs of services. There is no regulatory body to control the prices or keep a close look at the kind of serives that hospitals and diagnostic centres provide. “It definitely lacks transparency; for instance, questions are raised on why there is no transparency in pricing or why unnecessary procedures and tests are suggested to the patients without there being a requirement for them. Another problem with commercialisation is lack of attention to the low income group. Unfortunately few initiatives are aimed at the lower income group; unlike other industries like banking, retailing, etc. Even if one wishes to provide good quality healthcare for the lower income group, one needs to create a special model which would suit the rural areas of the nation in terms of affordability as well as quality. Hospitals today want to leverage the business potential in the cities and my only apprehension is that are they going to enter the rural areas with the same model,” explains Jalan.

What lies ahead…

Private health care is the way of the future; organisations need to keep a strong check on themselves and formulate their own method of ensuring an audit of their work to ensure that there is evidence-based healthcare delivery and ethical practice. “This sector demands high level of ethics and hospitals and other companies need to understand this and follow an ethical path. It would be the best way; regulation by a statutory body has its pros and cons. Such a body should have representatives from the industry and it should be independent of the government,” expresses Jairam.

There are organisations that are clear with their ethical lines and integrity and want to work purely for the benefit of the people. These are people who do not engage in commericalisation; there are other organisations and people who tend to exploit their patients. “Commercialisation should focus on creating value for money, exploitation needs to be tamed and ethical and transparent systems should be followed.  If this path is followed then good quality hospitals can be created, which even international patients would find relevant as good quality services at lesser cost will be provided, which will in turn help increase medical tourism. If companies follow this path then commercialisation would definitely be more advantageous than it currently is,” believes Jalan. 

By Jasleen Kaur Batra (jasleen.batra@infomedia18.in)