Run! The merchants of death are angry!

Doctors are angry! Why? Aamir Khan has targeted them in two of his first four shows! And why not? After all, the show is called Satyamev Jayate! In a country where 17% of the population dies before the age of 40 and an increased healthcare focus should have been an imperative, the reality is that medicines for treatment of cancer patients — in one of the cases, 5.5 lakh Morphine and 52 lakh Morcontin tablets sent by the World Health Organization — that were supposed to be distributed free at all the hospitals in India, were dumped in the stores of hospitals beyond their expiry dates. What is important for the masses to know is that the medical mafia keeps doing such acts to enhance the profits of pharmaceutical establishments.

There are exceptions too —like the Shramjibi Hospital in Belur, West Bengal, which charges just Rs 25,000 for a coronary bypass, unlike the Rs 3 lakh others might charge. Yet, on the other hand, services rendered by many private doctors and by private/public hospitals are of such miserable standards that I get the impression that these places are infested with ‘merchants of death’.

One of the key issues in the healthcare industry is recommendation of specific costly medicine brands by the doctors who deliberately omit recommending the non-branded generic drugs, which essentially have the same composition and effectiveness as the branded ones and cost dramatically less — sometimes even 1/100th of the branded drug. This is exactly what Aamir tried to point out. His contention was, “A strip of 10 tablets of Amaryl costs around Rs 125, while a strip of 10 tablets of the salt Glimepiride costs Rs 2. Both are essentially the same (and are used in the treatment of diabetes). We pay approximately Rs 123 more for the brand name.” The drug industry spends on an average Rs 2 lakh per doctor per year in soliciting business and promoting branded medicines. It is no wonder that branded medicines are so costly and doctors love them. Aamir again rightly points out, “Roughly 25% of all ailments go untreated in India because of financial reasons. Think of the difference generic medicines can make to every Indian!”

Similarly, investigations for diagnostic purposes recommended by doctors are often superfluous and are priced exorbitantly. One of the reasons is the commission paid to the doctors. Also, since foreigners from developed countries are coming in droves to get treatment in India, globalisation has led to an increase in the cost of treatment in Indian hospitals. The average cost of hospitalisation has increased by more than five times in a span of just 10 years. This can explain surely why only the super-rich and the rich can dare to undergo treatment in super-specialty private hospitals.

We must take up the fight against reservation of treatment in modern hospitals for the creamy layers of Indians, whatever the caste. The only way to get rid of our very own ‘merchants of death’ is to devise a National Health System geared to Indians of all castes and classes, inclusive of people at starvation level (around 40% of present official poverty level), destitution level (present official poverty level) and the true poverty level as defined by IIPM Think Tank (which has a poverty benchmark that is 50% above the present official poverty level). Here, one may think of adopting a variant of the National Health System in Cuba, where health services are comparable to that in UK, though at only around 1/10th of the cost. More than a lifetime of an average Indian has passed after India achieved Independence. It is high time we did away with the famine of food as well as of medicine. It is high time we built in each block-level unit at least one hospital, modeled on the lines of the Shramjibi Hospital, humanised and efficient.

No doubt, Aamir’s show is garnering a TRP of only 3 or so and even the masses want him to be more combative than the ‘now school teacher, now teary’ mode of his, since unlike an Oprah, Aamir is known to be an actor and is not a woman, so his tears will often be looked upon by the public as melodrama. Also, his program almost looks like a deglamorised version of The Oprah Winfrey Show with poorer looking Indians vocalising their pains; Indians who give the TRPs now appreciate glamorous looking shows, especially if they have to get up early on Sunday morning! But Aamir’s case against the doctors is absolutely praiseworthy and specifically so in the light of our existing health system! Instead of taking it negatively, it’s time for the doctors to be true to their profession and support the cause of generic medicines and it is time for us to humanise our health system and make it efficient and provide for budgetary allocations for the same. We can do it and we must do it now.

— The writer is a Management¬†Guru and Hony. Director of IIPM Think Tank

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