The coronavirus pandemic has revealed in tragic detail the inadequacies of India’s healthcare system. While public healthcare, especially outside of major cities, is at best rudimentary, the private health sector, which accounts for the bulk of the nation’s healthcare facilities, has come up short in this time of crisis.

Why is it so? What are the deficiencies in the health sector the pandemic has revealed? How have they affected the country’s handling of the coronavirus outbreak? What needs to be done now to minimise the damage from the pandemic? How can the health sector be strengthened in the long run? Do public-private partnerships offer a solution?

To discuss such questions, Abhinandan Sekhri of Newslaundry hosted an expert panel comprising Dr Naresh Trehan, chairman and managing director of Medanta Hospital; K Sujata Rao, former union health secretary; Oommen C Kurian, head of health initiative at the Observer Research Foundation.

Asked whether Indian hospitals have the excess capacity to deal with the outbreak, Trehan points out how hospitals dedicated to treating coronavirus patients have been set up in every district and how private hospitals such as Medanta, Fortis and Artemis have collectively adopted a hospital in Manesar, Haryana, and turned it into a Covid treatment facility.

Citing the example of Gurugram, he says there appear to be enough hospital beds to deal with a medium-sized surge. It’ll depend a great deal on how the lockdown is lifted as well, he adds, “As important as the lockdown was, even more important is in what sequence and what manner it is lifted.” (Disclosure: Trehan is married to Madhu Trehan, the co-founder and former editor-in-chief of Newslaundry.)

Asked about the treatment costs in private hospitals, Trehan explains that those with insurance are being charged under it, and those who cannot afford treatment are being treated for free.

To understand how the public-private model works, Abhinandan asked Rao to explain its intricacies and its shortcomings. “When it comes to infectious diseases,” she explains, “it’s a public good and it is something that the government is completely responsible for.” The private sector, she adds, cannot work on “charity basis” for long.

She mentions how in some states the governments have taken over private hospitals to deal with the coronavirus outbreak, “I don’t necessarily buy that, I really feel that whatever facilities the government has, we should exploit them fully.” Moreover, the numbers right now are manageable and providing for the extreme cases is where the government is coming up short. She doesn’t think it’s a sustainable solution for the government to expect the private sector to provide free care, but “they can come up with a fair rate that will have to be worked out and negotiated”.

Kurian argues that the policy debate in India is very polarised. He agrees that there is a problem of resources in the medical sector but adds that “there are ongoing public-private partnerships which can be leveraged to fit our needs for Covid response”.

He suggests making the Pradhan Mantri Jan Arogya Yojna universal. The insurance scheme covers around 50 percent of India’s population currently, he adds, but the “problem with it’s that most private hospitals get paid pretty late”.

Watch.

You can also listen to this conversation.

This stakeholder consultation is part of a project supported by the Thakur Family Foundation. The Thakur Family Foundation has not exercised any editorial control over the project.

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Update: This piece has been updated with a disclosure on Dr Naresh Trehan.

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