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Will the Modi government focus on ease of getting medical care?

Dr KK Aggarwal | Updated on August 17, 2019 Published on August 17, 2019

What patients want Easy hospital admission, appropriate care, transparent billing and seamless reimbursements   -  simonkr

Emergency care without delay is what patients need the most

We prefix ‘Dr’ before our names as a privilege and not a matter of law, because the law has long abolished titles.

But we are given this privilege as doctors because of our role in alleviating the suffering and pain of ordinary people. And at the heart of our role as modern medicine doctors is the significant task of providing emergency and urgent care. In fact, it is our dharma.

The Government needs to ensure that such emergency care services are made accessible to both ordinary and high-profile individuals, and that it is kept outside the ambit of commercialisation.

As we have recently witnessed, even politicians like Sheila Dikshit, Sushma Swaraj and Gopinath Munde had to be rushed to hospitals in an emergency and no acute cardiac care service was available to them at point of care. The acute cardiac care window is only four minutes, and we have the constitutional right to receive that at point of care.

The solution lies in increasing emergency care services in the Government sector. Every person has a constitutional right to health under Article 21 of the Constitution. Under the Directive Principles of State Policy Article 47, the state has the responsibility to provide emergency care.

Article 39 also lists certain principles of policy to be followed by the state. Also, if patients are financially unable to pay the hospital bill, their relatives should not find themselves in a position where they are forced to adopt illegal means.

Unfortunately, that is often not what transpires on the ground. Hospitals are known to deny admission to patients on ventilators or non-invasive ventilators, newborns with sepsis delivered outside their hospital; non-booked caesarean section cases; patients requiring acute terminal care; patients on dialysis and not on transplant list, and so on.

Often, with Government hospitals being overcrowded, patients who require urgent or emergency care invariably have no choice but to go to a private hospital and cough up a huge amount of money in just the first six hours.

Trauma centres effective

Delhi, though, has had a different experience. Ever since two major trauma centres were built, no cases of patient-doctor mistrust or distrust related to road traffic accident cases have come to light.

The reasons are that they do not refuse to admit the patient and also provide timely acute care. They do not force you to go to the private sector if you cannot afford the high costs of treatment in a private hospital.

The answer, therefore, lies in opening centres similar to these trauma centres to provide acute care, that is either free or subsidised, or place advance care “108” like ambulances within four minutes of people’s reach.

Also, all patients requiring emergency care, who are referred from government hospitals to private hospitals or other empanelled hospitals due to non-availability of beds, should be reimbursed on predefined CGHS, Ayushman Bharat or any other accepted rates.

Systems need to be put in place to smoothen a patient’s experience in getting medical care at a public or private hospital, in terms of getting admission and appropriate care and finally obtaining transparent bills and seamless reimbursements and payments. Such ease in hospitalisation will generate growing goodwill between patients and doctors, helping eliminate the culture of violence against doctors.

Getting emergency care to a patient without life-threatening delays is integral to the ease of access to medical care for citizens. The point is, will the Modi Government focus on this next?

The writer is President, Heart Care Foundation of India, and President-Elect Confederation of Medical Associations of Asia and Oceania. Views expressed are personal

Published on August 17, 2019
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