Saturday, September 7, 2024

Indian healthcare can rev up the economy and create jobs

Some readers may be too young to remember what the information technology (IT) boom of the 1990s felt like. It was a time of hope and wonder. It was a time when lakhs of families were uplifted from grinding poverty as sons and daughters got good salaries. Millionaires were created. Cities like Bengaluru were transformed.

We are at that cusp of history once again. Only, this time, it is the healthcare sector that could provide a similar impetus to lakhs of families and the economy.

Central and state governments have taken steps to make healthcare more accessible to Indians. But our healthcare coverage of tier 2 and tier 3 towns as well as rural areas is still not wide enough. The private sector today can do what the government cannot—take healthcare to every remote corner of the country, with a little support.

Making healthcare more accessible and affordable must be a key goal. The social impact of it would be significant and it can be achieved with little cost to the government.

Global sovereign funds and long-term investors are keen on funding hospitals in India. If the Centre exempts hospitals with over 100 beds built on over 100,000-sq-ft of area by using funds from Infrastructure Investment Trusts (InvITs) from GST, it could unlock a never-before expansion opportunity for the hospital sector.

This move could attract global funds to invest in building hospitals across the country, while Indians operate and manage them. These InvITs could potentially be listed as well, ensuring a sustainable source of capital for the sector.

Hospitals are largely concentrated in metro cities, with patients often travelling thousands of kilometres while sick or infirm just to meet a medical specialist. Building well-equipped hospitals with specialists in a variety of branches of medicine would need to be incentivised. A 25% capital subsidy and a 5% interest subsidy on healthcare investments for a period of five years would go a long way toward achieving this goal.

The NCD burden: Non-communicable diseases (NCDs) like cardiac ailments, stroke, cancer and diabetes are predicted to escalate to epidemic proportions in the coming years. This will be a much larger challenge than covid. The World Health Organisation says that 74% of all deaths globally are due to NCDs.

In India, we have witnessed a doubling of deaths due to NCDs in just 26 years. According to a report by the Indian Council of Medical Research (ICMR), deaths due to NCDs went from 37.9% in 1990 to 61.8% in 2016.

Incentivising the private sector to build more hospitals that can service even the most remote areas will help in bridging the accessibility gap for our country-folks.

The service accessibility challenge: India has chosen to adopt a mix of healthcare models—we have both public and private sector health insurance as well as taxpayer-funded public health. Yet, many families are driven to debt with out-of-pocket expenses when faced with ailments.

At present, only 4% of the country’s population has health insurance coverage. This has led to 86% of people spending out of their own pockets for treatment.

Catching NCDs early will be the best way to limit out-of-pocket spending on healthcare. The government can encourage regular health check-ups by increasing the tax exemption for master health check-ups under Section 80D of the Income Tax Act to 50,000 per annum for a family.

Bringing OPD consultations and diagnostics within the ambit of health coverage would greatly incentivise patients to visit doctors early and ward off or control NCDs without worrying about costs.

Skilling India: Akin to the IT boom of the 1990s, India is now on the verge of another economic transformation. And the healthcare sector has the potential to drive this change.

The dream of becoming an economic superpower can only be achieved when millions are lifted out of poverty. Skilling the youth of India to become nurses and paramedics can help do that.

The Western world is struggling to cope with an ageing population. Skilling Indians in caring for the elderly can help them get lucrative jobs abroad. India too has a vast ageing population and the need for professional caregivers will increase manifold over the next decade. We need to be prepared for this.

While healthcare will gain vastly from advances in artificial intelligence (AI), human intelligence and empathy must go hand-in-hand with technological progress to create the appropriate level of care for our people.

To this end, it is imperative that the government increases the number of nursing and medical colleges as well as doubles the number of seats. Degrees need to be harmonized so that they are accepted all over the world. Organizations that provide technical skills for paramedics need to be given special incentives.

The government should also permit partnerships between global and Indian entities to develop a Global Development Programme Centre that would provide the most advanced and structured skilling, so that our youngsters can find jobs abroad and financially help their families back home.

This can be India’s century and it needs to be a healthy one. A healthy society will benefit not just the country but the world.

The author is managing director, Apollo Hospitals. 

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