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India Aims for the World's Biggest Health Care Overhaul

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Re: India Aims for the World's Biggest Health Care Overhaul

#51

Post by pavanred »

thevardanian wrote: post #23
allpratik wrote: post #21

Earlier quoted context omitted.

This is totally wrong information about the current state of affairs of India. 1. Ease of doing business The Indian government had stopped LLP registrations all together for no official reason. For Pvt ltd registrations from past June 10th rejections to form a new company or even subsidiary company has skyrocketed. Source: LLP halt is reported in media, which still has some spine to stand against the government. Rega…

1. Business Ranking "India climbs global business ranking. But it's not that simple" https://money.cnn.com/2017/10/31/news/economy/india-ease-of-... 2012 - 132 2013 - 132 2014 - 134 2015 - 142 2016 - 130 2017 - 130 2018 - 100 http://www.doingbusiness.org/data/exploreeconomies/india Samsung is also opening the world's largest Mobile phone manufacturing plant in India. That's a tremendous investment from them. 2. Corru…

Care to also publish rankings of the country over the years in freedom of press, law and order, mob violence, transparency, economic growth, journalists/writers murdered, appointments/shortages of RTI commissioners, RTI rejection rate, lack of lokayuktas, appointments/shortages of judiciary by govt etc. (or just look it up for yourself)

> There have also been tremendous investments from the government in green tech, like solar.

The goal setup was a 100GW of solar capacity by 2022. It was about 2KW in 2015 and is about 20KW in 2018. We are most definitely not going to achieve the goal, perhaps not even get close. Lofty goal, sound familiar? I am sorry, I take lofty goals and promises of the Govt. with a pinch of salt until I see some actual implementation.

Re: India Aims for the World's Biggest Health Care Overhaul

#52

Post by pavanred »

thevardanian wrote: post #38
mandeepj wrote: post #18

Earlier quoted context omitted.

> Across almost all metrics, infrastructure, corruption, ease of business, electricity, even cleanliness India has improved on You are drinking ruling party’s a lot of cool aid

What are you talking about? There are very few metrics that you can list that show a decline. So how about you show me the data for decline.

How about freedom of press as an example (World Press Freedom Index)

2018: 138

2017: 136

2016: 133

A good rule to follow, formulate an opinion after you gain enough facts to argue the other side, else you'll keep seeing only what you want to see.

Re: India Aims for the World's Biggest Health Care Overhaul

#53

Post by vidarh »

petilon wrote: post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

Yet somehow this works e.g. in France, or for GPs and dentists in the UK. A lot of socialised universal healthcare systems socialise the insurance part but rely on private actors to deliver all or part of the service. They tend to keep the prices down by either regulating them, or having the socialised insurance provider negotiate a fee structure on the basis that the insurance provider can offer the lowest amount that gives sufficient capacity of the required standard.

E.g. in the UK, general practitioners negotiate as a block, and individual practices can take or leave whether or not they want to provide services for the NHS or private services. The NHS needs to offer contracts attractive enough for enough practices to take NHS patients and ensure continued recruitment, but no better. It's a market, but skewed by a very large actor with a strong interest in keeping prices down.

If they "just" let people shop around without regulating or negotiating prices (and leveraging the volume of business), then it would be a problem. But having the consumer participate in driving costs down is demonstrably not necessary. On the contrary I'd argue it's counter-productive, because when dealing with people with less money it creates a risk that people gamble on options that cost less in the short term at the expense of creating higher costs in the long run.

Re: India Aims for the World's Biggest Health Care Overhaul

#54

Post by vidarh »

intended wrote: post #32
raincom wrote: post #30

The number of seats in Indian medical colleges is 91040. Why not increase these seats by 10 fold. In a couple of decades, that can help.

Because scaling this IS hard.

Notably, it's unusually hard in that actual practice on humans is still a necessity since there aren't good enough training analogues to substitute for real cases, so even if you managed to scale the basic training it's still an unsolved problem to scale up the number of doctors rapidly in safe way.

E.g. you can't just educate 10x as many heart surgeons without actually having 10x as many cases for them to scrub in on that you have experienced heart surgeons to lead on unless you're prepared to kill a lot of people in the process.

Re: India Aims for the World's Biggest Health Care Overhaul

#55

Post by pkphilip »

thevardanian wrote: post #7
sremani wrote: post #5

The beauty of (Indian) democracy is that every 5 years the year before election an innovative world saving scheme that is expensive would be implemented or started.

Across almost all metrics, infrastructure, corruption, ease of business, electricity, even cleanliness India has improved on. This isn't just another election year innovation, this is just another list of innovations that have been added, which also include things like investments in clean energy, and providing rural impoverished citizen with gas to cook (people in rural areas would cook in wood fired stoves that wou…

The best way to judge your theory that the overseas investors are so very optimistic about India is to simply follow the money.

Contrary to what you are saying, the data actually says that there is a huge outflow of funds from India.

https://www.moneycontrol.com/news/business/markets/fiis-pull...

Re: India Aims for the World's Biggest Health Care Overhaul

#56

Post by modi15 »

rahulthewall wrote: post #48
modi15 wrote: post #46

Interesting comments here but imo India already has a pretty fantastic healthcare system. People who argue against spend some time understanding the US healthcare system and the disaster it is. India already has health insurance by private companies but its probably not used extensively. Something like this is basically a government run insurance scheme - it will most likely be a no-frills service, offer standardized…

>That being said most of India has access to govt. run hospitals which offer near free services. Nothing could be farther from the truth. I would recommend the following study, published in The Lancet >In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of…

I dont really need the study. I stay here and experience this on a daily basis. There is nothing in the study which contradicts what I said. People do visit private hospitals if public hospitals dont meet their needs and such visits can definitely bankrupt people. That doesnt have to mean that the govt. hospitals are doing a bad job or that private hospitals are inaccessible.

Re: India Aims for the World's Biggest Health Care Overhaul

#57

Post by neffy »

petilon wrote: post #25

>> which would offer the poorest half of India health insurance to apply toward private hospitals This is a terrible idea. Did they learn nothing from the failure of Health Care in the United States? When insurance pays for everything patients stop worrying about costs, which in turn causes hospitals and drug companies to raise prices. This is what has caused Health Care to fail from a costs point of view. The soluti…

There speaks the healthy...

... when you or your family are on death´s door because of an accident/cancer/heart attack/stroke/bug/immune disorder etc., you may find comparison shopping isn´t the first thing that comes to mind.

Re: India Aims for the World's Biggest Health Care Overhaul

#59

Post by rahulthewall »

modi15 wrote: post #56
rahulthewall wrote: post #48

Earlier quoted context omitted.

>That being said most of India has access to govt. run hospitals which offer near free services. Nothing could be farther from the truth. I would recommend the following study, published in The Lancet >In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of…

I dont really need the study. I stay here and experience this on a daily basis. There is nothing in the study which contradicts what I said. People do visit private hospitals if public hospitals dont meet their needs and such visits can definitely bankrupt people. That doesnt have to mean that the govt. hospitals are doing a bad job or that private hospitals are inaccessible.

>I stay here and experience this on a daily basis.

Your anecdotal evidence is not worth more than a proper study.

>That doesnt have to mean that the govt. hospitals are doing a bad job or that private hospitals are inaccessible.

Private hospitals, in India, are indeed inaccessible for the majority. As for government hospitals, we don't have enough.

Re: India Aims for the World's Biggest Health Care Overhaul

#60

Post by PeterisP »

thatfrenchguy wrote: post #36
PeterisP wrote: post #2

The math doesn't check out. "Each family would get more than $7,200 in annual coverage"; "better health care for 1.3 billion people" and "Modicare is expected to cost the Indian government less than $2 billion annually" seem to be mutually exclusive. There's no reasonable way for health insurance/coverage to be so underutilized that on average only $1-$2 of $7200 would get used.

Coverage up to X does not mean people will use X. 7200$ is a shit ton of money in India.

Sure, people will not use X but they'll also use more than 0.02% of X; Even a ridiculously unrealistic low utilization of 0.2% is 14$/year and would cost ten times more than the "estimated" cost.
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