Health-care vs. Medical Tourism

Government of India has set up the National Accreditation Board for Hospitals (NABH) and National Accreditation Board for Laboratories (NABL) to strengthen the regulation of healthcare industry in India but the major purpose behind the move is said to be the intent to encourage medical tourism. India is trying to break into the humungous (and growing) global market of Medical Tourism currently dominated by Indonesia, Malaysia and Thailand. While India might be just a beginner but it has some inherent advantages of being recognized as the land of Yoga, Meditation and other parallel forms of medicine in addition to having doctors well qualified in modern medicine.

While the increase of medical tourism and induction of accreditation services will improve the state of existing healthcare in India, it might not help in making up for the shortage of healthcare facilities. Accreditation will primarily be sought by large hospitals, or medium sized clinics in areas where the demand for premium healthcare facilities is high and people have the paying capacity to afford these facilities. It may also be sought in areas where there is shortage of quality healthcare but people are ready to pay for it. However, in small towns, villages and unprivileged areas (read: slums) where there is a shortage of healthcare and people do not have the paying capacity, accreditation will not work. Villages where the local compounder is the ‘daactar sahiib’ and a room in the pathshala serves as the dispensary, accreditation makes little sense.

The government should recognize that for a country of a billion inhabitants, healthcare is more important as an infrastructural component than just as an industry. All efforts to regulate or improve an industry should use the principle of ‘Carrot and Stick’. While accreditation serves as the carrot for those who can afford it, a stick is needed to ensure that healthcare

1. does not remain scarce
2. does not fall below a minimum standard irrespective of whether people an pay for it

If either of the above goals is not fulfilled, the other automatically fails. If healthcare is a scarce resource, there will be (legal or illegal) ‘low cost’ clinics which will operate below minimum standards to save costs. On the other hand, even if private clinics make healthcare abundant, in absence (or weakness) of a regulating agency, some of these would operate below standards, to top-up profits.

Setting up of NABH and NABL is a step in the correct direction, but this needs to be supplemented soon enough with a more robust, organized and coordinated framework for managing healthcare (minimum and premium) facilities in India for Indians as well as Medical Tourists.

PS: Those waiting to read about my Uttaranchal experience will have to wait. I am awaiting photographs of the trip and also am deficient on time. Hopefully, I will post something on that front over the weekend.