It is unfortunate to learn that despite being a basic necessity, healthcare fails to earn a universal definition in India. For a country which is growing exponentially, good health continues to be a luxury available not to all. Healthcare needs and nature of treatment vary across the socioeconomic categories. While a financially well person may want to see a doctor even at the mildest of a disposition, someone below the poverty line decides to do so only when the ailment starts to hamper his or her daily work.
The state of healthcare is dismal for the urban poor when compared with the economically weaker section living in rural areas. They are more exposed to hostile environments, unhygienic surroundings, lack of basic necessities, income-insecurity and vulnerability to diseases. What makes it more serious is high medical and treatment costs. Since most of them do not have health insurance coverage, medical expenses dig a big hole in their pockets.
Although the government has taken certain initiatives for public health and made investments in healthcare, it does not seem to be sufficient. The patients from BPL still have to shell out a big sum of money from their pockets. Healthcare expenses consume a significant part of their monthly household budget. This, coupled with the absence of insurance coverage, is pushing them further towards poverty.
In this scenario, there are two conditions usually in which the financial inability turns detrimental. Firstly, when a family member of the family falls ill. A major part of the household finances goes into the treatment. Besides, it incurs additional expenses such as transportation, medication, opportunity cost due to the inability of the income earner to go to work. For a family which has to struggle for a daily bread, such circumstances can prove to be a big blow.
The second condition is quite grave where the sole income earner of the family falls sick or dies. This becomes a real catastrophe for the family whose future has suddenly gone murky and who do not know how they are going to manage and survive in days to come. Over and above this, they have to face severe difficulties while looking to arrange a loan to fund the treatment especially in a situation where they do not how they will pay it back.
While this all sounds deplorable, it is not all. The implications are even more dangerous than this. Generally, in case of medical attention, the urban poor have two options – government hospitals or private treatment. According to a recent survey, even the economically weaker population prefers to opt for a private treatment. The reason is that at a government healthcare facility, there are numerous patients waiting to be consulted and treated and it takes a lot of time. And for a daily wage earner, this would mean a significant opportunity cost or a lost income. Moreover, the infrastructure at a government facility is far from standard. Now let’s talk about private hospitals. Although preferred, the private treatment comes with a sky-high cost for the population segment we are talking about here. Most of them cannot afford to undergo a private test, medication and treatment. And this has given way to a disturbing mode of treatments. Many quacks or unqualified doctors have started to crop up in the poor neighbourhoods and people prefer to take their help in case of medical needs. Even if their treatments and medication are not effective, or sometimes fatal, they are friendly to the pockets of the poor. The same survey stated that as many as 15% patients from the urban poor population take recourse to such quack treatments in their vicinity. This certainly appears bad because even if such treatments are helping the patients as of now, their ill-effects are surely going to emerge in future, leaving people with a poor health and additional health expense, possibly more than now.
Below are the key variables that decide the healthcare affordability of an urban poor family.
- Number of family members
- Number of earning members
- Occupation of the earning member
- Number of members aged 60 years and above
- Number of members fallen sick
- Type of treatment (Public, Private etc.)
So, the healthcare model for the poor in urban geographies requires a serious revamp. A need of a good health is casting a negative effect on them. Most of the times, they do not have proper access to quality care and even the most common and basic diseases pose a catastrophic threat to them and incur a financial burden subsequently. And when they do, it is well beyond their affordability. Additionally, the treatment costs them time which, for a daily wager, can be monetised as a short-term as well as long-term loss.
It is high time the government should allocate more fund for public health, improve healthcare infrastructure and encourage everyone to avail government insurance scheme. After all, health should not be a luxury available to a few.