As a country that has always been in the spotlight in terms of inadequate healthcare and grossly mismanaged health facilities, India’s healthcare has evolved for the better, drastically in the recent few years. USA’s healthcare, on the other hand, is ranked as one the highest globally as what makes their healthcare stand out is their focus on infrastructure and new technologies while excelling in preventive measures.
How Globalisation transformed Indian Healthcare
The advent of globalisation gave Indian healthcare a new turn. Indian healthcare has become one of the largest sectors in terms of revenue and employment and is increasingly attractive to foreign investors due to its low costs and large, English-speaking workforce. These reasons have contributed to the healthcare system receiving sizable funding for foreign investors. Private healthcare facilities are rapidly progressing. India is home to immense opportunities in terms of medical tourism (elective surgeries and Ayurveda) and the emerging healthcare market. All in all, Indian healthcare has seen worthy achievements and yet the Indian government's expenditure on health is shockingly low, which is one of the root causes of low standards of health. It was only after the pandemic that the expenditure rose from less than 1% to 2.1% of the GDP, which is still inadequate. Inequality of growth is evident as rural areas’ facilities are underdeveloped and inaccessible while urban areas experience better developed healthcare. India also experiences a shortage of medical personnel.
India & the USA Healthcare systems
The USA, a global superpower and developed nation; India, a rising power and developing nation. Looking at the two largest democracies in the world, it is astounding how similar yet how different their healthcare systems are.
A country with a long-standing history, Indian healthcare has been around since ancient times. Early efforts were focused on treating and rehabilitating the sick. The notion of prevention of spread and preventive medicine came along later. Post 1951, Indian healthcare saw monumental improvements. National programmes were initiated to control the spread of diseases and general medical infrastructure improved. In contrast, the USA's healthcare system has existed since the early 1700s. Progressively, healthcare took a front seat in terms of budget allocation and quickly moved to achieve the status of developed and superior healthcare globally.
A complex yet superiorly developed system, USA’s healthcare system is a well oiled machine involving both public and private institutions. Private insurance plans are extensive and cover most bases; however, these plans are not affordable for all. The government funded programs aim to aid low income individuals but such plans offer less coverage. The USA does not have a universal healthcare system and the expenses are such that individuals opt to seek medical attention in other countries. These high costs can be attributed to administrative expenses, corporate greed and price gouging. So while the care offered is of the best quality, it comes at a cost which many can’t bear, forcing them to opt for other options.
The most evident area of difference between the two nations is the Public healthcare system. India lacks on this front due to barriers such as inadequate sanitation, drinking water facilities and nutrition. The USA enjoys a higher standing in this sense as their healthcare expenditure per person is the highest in the world. India’s total expenditure on healthcare in terms of percentage of GDP is 0.35% whereas the USA’s expenditure was as high as 19.7%. The difference in budget allocation is a major contributor to the difference in quality and accessibility of healthcare.
The nature of healthcare also differs. In India, private healthcare is better in terms of quality and service but it is unfortunately very expensive. In the USA, The Patient Protection and Affordable Care Act (PPACA) provides accessible, affordable and quality healthcare to all Americans covered by insurance. In India, the government does provide healthcare, however, not all citizens are able to avail its benefits as the provisions are inadequate with respect to India’s large population.
The US health insurance is extensive and covers many medical fronts whereas Indian health insurance has a very specific and limited scope which makes seeking healthcare in India relatively expensive. Overall, the USA's healthcare system is more inclusive, they have better equipped staff and modern infrastructure due to adequate financial resources. In India, accessibility of healthcare is still a major obstacle as the population is large, finances are an obstacle and systemic problems are prominent. There is also discrimination in India when it comes to providing healthcare in terms of caste and gender making healthcare a privilege not every Indian citizen can afford.
Covid Response-Where the tables turned
A nation that is always termed as one with a ‘developing healthcare system with a long way to go’, turned the tables around during the Covid-19 Pandemic. The healthcare system was at its strongest and most resilient during these uncertain times. India optimised its local support by making use of local resources to deliver support and home care. Medical professionals were equipped to conduct online consultations and telemedicine. With exceptionally high case numbers, the public and private healthcare sectors of India worked in harmony to ensure aid was provided to all in need. India set up quarantine camps, makeshift hospitals and made arrangements for additional oxygen to ensure that patients were not medically compromised due to lack of resources. The Indian healthcare system set up war rooms, which are disaster control rooms set up to oversee the cases arising in the ward, stemming the spread of covid. These were indispensable as they advised and counselled people, making medical care more accessible in times when stepping out of the home seemed impossible. The Indian system also provided mental health care helplines and counselling for the benefit of society.
Applause-worthy credit must be given to Indian pharmaceutical companies who successfully researched and created vaccines. India’s vaccination drive was uniquely successful as despite a large population, India, in a phased manner, delivered 1 billion jabs in 9 months.
On the other hand, the country famed for its stellar healthcare system, the USA faced innumerable challenges. The USA has reported the highest cases and deaths in the world since the onset of the Pandemic. The unexpected rise in demand for health care services crippled the USA as it increased the demand for specialised acute care that overtaxed hospitals and imposed unexpected costs. The decline in demand for routine services reduced providers’ revenue. Various medical health providers were laid off which proved to be a mistake as when cases skyrocketed, there weren’t enough healthcare providers. The USA healthcare system revealed its true colours when even in the face of a global crisis, there were reports of racial and ethical disparities. The United States did not make testing widely available early in the pandemic which proved to be another critical setback. The marginalisation of public health, dismal quality of care and privatised market-based healthcare system exposed long-standing problems in the system.
Nonetheless, the two nations had their share of positives and negatives during the pandemic. The second wave in India brought the healthcare system to its knees. The pandemic revealed structural weaknesses in the Indian healthcare system. Hospitals started running out of beds and people were desperately searching to provide oxygen and other critical medical supplies. A lack of political interest in health and inadequate spending on healthcare came to the forefront as India struggled through the surge of cases. While its healthcare was in shambles, the USA took critical positive steps to help improve the situation. The USA made tele-health more flexible and easy to implement and access during the pandemic. They also laid increased emphasis on mental health and set up resources and tools that individuals could access to better their health in the trying times
What strongly came across is that at all times, access to facilities must never be hindered and nations must work towards making their healthcare accessible to all. The reality of discrimination indicated the importance of policies that will make the system strong and free from bias. The importance of telehealth also came to the limelight indicating that nations can adopt this method to improve accessibility. Nations must invest and build their systems to be resilient, efficient and non-discriminatory to provide the best possible healthcare to their people.