When English-American poet W.H. Auden famously said decades ago that "health is the state about which medicine has nothing to say", he was perhaps referring to the universal inequities in health. Such inequality is stark in India today. A burgeoning bulk of well-heeled city slickers benefits from progress in medical science when battling diseases triggered by sumptuous lifestyles. At the same time, the urban and rural poor cannot access simple interventions against infectious diseases like malaria and tuberculosis.
At a time when developing nations are at the forefront of economic growth, their inferior health systems and poor infrastructure make those growth stories appear farcical. New-found access to procedures like liposuction and hair transplant look outlandish when juxtaposed with the millions who struggle for basic healthcare delivery.
So what explains the poor preventive capabilities and the skewed structure of healthcare delivery in one of the fastest growing economies of the world? A lot, actually. Consider: Less than 10 per cent of doctors practising modern as well as traditional medicine are available for rural health care; and 75 per cent of the available medical infrastructure is based in urban settings. This in a country where around 72 per cent of its population resides in rural areas.
Ratan Jalan, founder of Hyderabad-based Medium Healthcare Consulting, says in frustration: "Health care is not just hospital beds. All companies want to create monuments. At present, most have very short-sighted views. Look at what happened in hotels or airlines (where segmenting as per affordability has taken place) when a different kind of thinking was applied."
Drawn by the inequities in access, some healthcare firms have begun to think differently. Result? The buzzword "preventive healthcare" is being increasingly heard in corporate India. One example: Diagnostics laboratories chain Metropolis Healthcare, which is entering smaller cities and towns in its quest to prevent deaths from diseases like malaria because of late diagnosis.
"Forty per cent of cardiac patients die before they reach a doctor," says Amol Naikawadi, Joint Managing Director, Indus Health Plus, who is making prevention his business model. Indus, which provides high-end preventive health care, hopes to lower costs by as much as 50 to 70 per cent for some tests by gaining economies of scale. For his efforts, the finance and accounts executive-turnedhealth entrepreneur closed 2009-10 with a turnover of Rs60 crore and profit margins of 9-10 per cent.
However, private enterprise alone will not be sufficient. And entrepreneurship will look more convincing if Naikawadi and his ilk can do their bit to alter the skewed structure of healthcare delivery.