The Indian Medical Association, Kerala Chapter, has come up with several suggestions for the political parties ahead of the Kerala Assembly elections for bringing in a drastic change in the health sector in the state.
May be termed as the IMA Manifesto for the coming assembly polls, the Association put forth suggestions to improve public health, policy shifts for overall health improvement and streamline medical education.
IMA Kerala Chapter President Dr P T Zacharias and Secretary Dr P Gopakumar highlighted the need to protect the fundamental right of every citizen towards quality health care and the new challenges in the field of health. As such, they said that the IMA has submitted some proposals for the consideration of political parties.
1. State needs a proper and scientific health policy
- Increase budget allocation to 12 per cent for health care;
Prioritize primary immunisation methods, social determinants, medical education and research. Fund allotment should be based on the percentage of patients seeking treatment in any particular system. Introduce a new system to ensure use and effectiveness.
The IMA noted that 3.3 per cent of the Indian population is pushed below the poverty line every year because of the rising treatment cost. This was because the allocation for health care is very small, the Association said. It said that allocation stood at around 1.2 per cent for years. As per the NSSO statistics, health care costs in India stood at 80 per cent, which was the highest in the world. Developing countries such as Sri Lanka and Malaysia has reduced it to 60 percent or less. In developed countries, it was less than 30 percent.
- Universal health care for all:
The IMA calls for direct public outreach to bring development results to the people. It also called for abandoning insurance-based funded programs. Instead, they wanted the government to fund directly. The right to health should be enshrined in the Constitution.
Though Universal Health Care was part of the Millennium Development Goals, which were to be achieved by 2015, it has to be achieved by at least 2025, the IMA pointed out.
The present Universal Health Coverage only target certain socio-economic groups and geographical areas. The proposed AYUSHMAN BHARAT program covers only 40 per cent of the population. As all public funded health programs are proposed to be integrated into that platform, only a segment of the population will be included in it, the IMA said. The Association wanted to develop a comprehensive program for covering the entire population on preventive and primary health care.
4. Health must become a constitutional right of citizens and financial assistance, delivery and accessibility must be unimpeded;
The IMA noted that even public funded health programs covering vulnerable sections of the society involved insurance-based systems. The various conditions inherent in such insurance-based systems make it difficult for people to obtain the promised coverage. While the government claims that in the insurance-based system, it provides health care of Rs 5 lakh per citizen, the actual amount spent is less than Rs 1,000, which is too small to achieve the specified target. Insurance models in developed countries are proving to be more of a failure as the sole model of health care, the IMA said.
5. Focus more on primary care and disease prevention:
The IMA wanted to set up more primary health centers and sub-centers. It maintained that the concept of a Wellness Center for providing specialty care in primary care centers would weaken primary and immune health care and will lead to major consequences. It would only create a huge gap in the field of primary care. As such, the IMA was for increasing the number of primary health centers and sub-centers.
6. Implement a Comprehensive Kerala Medical Council Act
7. The State Health Service Sector needs to be revitalised by incorporating professionalism. The three-tier system of health delivery should be established by upgrading and strengthening Primary Health Centres, Community Health Centres, THQ, DH and MCH. The IMA also called for strengthening the concept of family doctor by utilizing the services of family doctors and clinics in the private sector.
8. Myxopathy: Unscientific mixing is not required in treatment systems. The IMA said that they were against including modern medical curriculum in traditional and alternative medicine courses. Such an unscientific approach posed a great danger to public health, they added.
9. Protection of Small and Medium Nursing Homes;
These institutions are the backbone of the healthcare sector, providing 24-hour ethical and responsible healthcare and providing secondary health care. Small and medium hospitals should get tax breaks and other benefits as is given to IT sector and small and medium enterprises. The IMA wanted single window clearance for these health care institutions.
According to NSSO data, these small and medium institutions provide 70 percent of health care. Noting that programs to support such hospitals was a necessity, the IMA wanted the government to assign such hospitals to provide designated services on a participatory basis.
Abolish taxes on medicines and hospital equipment to reduce the financial burden on patients.
10. Healthy Food Policy: Enforce strict legal measures to prevent adulteration, impose health tax on junk food, tobacco and alcohol, restrict use preservatives and pesticides, and promote safe transportation and food storage.
11. Ensure proper disposal of waste in hospitals, domestic and commercial establishments.
12. Safe environment for doctors: the hospitals should be declared a Special Protection Zone and any form of violence should be strictly dealt with.
13. Social Security for Doctors: The government should establish pension and other social security measures for doctors.
14 Setting up an accreditation council like NABH
15. Establishing a Comprehensive Medical Insurance scheme for those who cannot afford medical expenses
16. Setting up Mono Faculty Medical University
17. Giving autonomous status to the medical Colleges in Thiruvananthapuram and Kozhikode and transforming them to the level of AIIMS
18. Strengthen steps for the prevention of infectious diseases
19. Start PG courses in family medicine, geriatric medicine and emergency medicine
20. Establishment of pain and palliative care in all Taluk and District hospitals. Starting de-addiction centres in district hospitals.
21. No trade unions in Hospitals