American Corporate giants Blackstone and KKR have been acquiring private hospitals in Kerala on a war footing. If not regulated properly, it will have very adverse consequences for the Kerala model of health delivery, which has been held as a model for other parts of the country and the world.
The only motive for the corporate takeover of the private hospitals in Kerala is profit. They intend to introduce the system of medical care prevalent in the USA based on the principlethat no health insurance, no treatment. In this system, the insurance companies decide what treatment the patient requires, not the doctors. Health facilities will be run by MBAs, not medical practitioners.
Medical expenses in America and Europe have become so huge that Indians living in these countries and even foreigners travel to India and get the treatment at one-tenth of the cost in these countries. For example, one of my nieces working as a nurse in Ireland had to do a dental surgery, the cost of which was 1000 Euros. She flew down to Delhi, got the surgery done, returned, and the total expenditure, which included some gifts for my family, came to 700 Euros. A saving of 300 Euros, so much for the health service in advanced countries.
Kerala's health model is based on a combination of private and public facilities in the ratio of 70: 30. While the 70 per cent private hospitals and clinics concentrate on curative medicine, in the public health facilities, the thrust is on preventive medicine. The private hospitals charge the patients according to the facilities, and government medical facilities are absolutely free.
There was a time in Kerala when it had Ayurvedic and traditional medicine practitioners present in every nook and corner of the State and very effectively attended to the medical needs of the people, including setting right complicated fractures and even ligament tears. When I was 12, I fell and injured my right hand.
First, I was treated by a general physician at the local dispensary. After three days of treatment, things did not improve, and I was taken to a nearby hospital run by the Church. The hospital referred me to the Kottayam Medical College Hospital, where I was advised to undergo an operation to set things right. But the doctor warned that my right hand will never be straight.
Worried, we got back home and at the advice of my grandfather, who had immense faith in Ayurveda, I was taken to an Ayurveda Vaidyan at Andoor near Palai, known by the name Plathottathil Kochu. In 15 days, he set my hand right and even today, at the age of 77, I am still playing badminton with my right hand!
When Kerala had only four medical colleges, they were all centres of excellence, but with the setting up of fourteen more medical colleges, the quality of the service has deteriorated because of a lack of facilities and adequate manpower.
In the sixties and even seventies, everyone knew the village dispensary doctor, and the doctor also knew almost everyone. The doctor was also accessible to people 24/7. With an increase in population and the building of super-speciality hospitals and the spread of unwanted and unregulated testing facilities, doctors became non-persons.
Sixty years ago, there was at least one or two friendly neighbourhood hospitals in every taluk or small towns run by one doctor and a few helpers. Until the year 2000, they provided basic essential services to the people at very low cost. But with the introduction of regulatory laws like the Clinical Establishment (Registration and Regulation) Act 2010, single doctor establishments have become unviable.
Health is a State subject; nevertheless, the Act has been adopted by 19 States and Union Territories — Arunachal Pradesh, Assam, Bihar, Haryana, Himachal Pradesh, Jharkhand, Mizoram, Rajasthan, Sikkim, Telangana, Uttar Pradesh, Uttarakhand and all Union Territories except Delhi. The Act is applicable to all types of diagnostic and therapeutic establishments belonging to all recognised systems of medicine, including single doctor clinics. The only exception is Clinical Establishments run by the Armed Forces.
Quality control is necessary, but it has to be affordable quality. Anything aimed at profit will go against the poor. In a democratic socialist country, the poor cannot be denied treatment. Also, some diseases are not easy to diagnose, and complications should not be mistaken for negligence.
With the entry of corporates into the health sector, health insurance will become mandatory, and expenses will double. Gradually and steadily, insurance companies will dictate terms for hospitalisation and treatment. Those who do not have insurance will be denied treatment.
Here, it is worthwhile to look at the motto of the two American Corporations. Blackstone, the world's largest alternative asset manager investing globally across private equity, real estate, credit, infrastructure and life sciences, manages over one trillion dollars in assets for institutional and individual investors by buying, building, and growing businesses for long-term value.
KKR, a leading investment firm, aims to deliver strong returns and shared success to those it serves and the world at large.