bsc banking services chronicle
bsc banking services chronicle Published this article WHO reiterated for Health for All especially in 2005 and in 2011 too though it used universal system including a method for prepayment of financial contributions for health care with a view to share risk among the people under the influence of World Bank in particular and the processes of liberalisation privatisation and globalisation in general. UN resolution in December 2012 further emphasised on it for overall human development and to be included in post-2015 development agenda. However World Bank in its World Development Report (1993) had ranked common health care interventions according to costeffectiveness its minimum health package for low income countries considered to avert 1/3rd of estimated disease burden and 1/5th of that in middle income countries. But unfortunately many common ailments (moderately severe injuries and chronic conditions like diabetes cataract hypertension mental illness and cervical cancer) were excluded from public funding in low income countries. Consequently due to structural adjustment or economic reforms during 1980s in the poorest 37 nations public spending on health per head declined by half due to cutse.g. in Mexico it declined up to 60 per cent. Following consequences are notable
1. Since State retreated from development interventions there was a massive decline in public investment in health sector like other social sub-sectors (education welfare of the deprived sections etc.)
2. There accrued a huge shortage of doctors and supporting medical staff leading to patients bound to go to private clinics
3. There was a shortage of medical equipment drugs and pathological facilities in public health institutionshospitals were reduced to mere writing of prescriptions and patients were compelled to buy medicines from the open market and to get pathological tests done at private labs at higher costs
4. Private doctors not only indulged in charging exorbitant fees but also prescribed unnecessarily more and costlier medicines as well as avoidable pathological tests
5. Due to the laxity of the State regulatory apparatuses even government doctors and supporting staff started giving more time at their private clinics
6. Due to the retreat of state in providing subsidised food sanitation facilities there was a rise in communicable and non-communicable diseases leading to long duration of morbidity and finally death
7. The phenomenon of free market (invisible hand) was based on the individual care considered as a private good but in most of developing countries there was no improvement in quality of health care equity and efficiency for the local people while the private insurance companies consultancy firms private pharmaceutical companies and private hospitals earned profits. Nowadays public-private partnership (PPP) modernisation value for money health insurance etc are the buzzwords in most of developed and developing countries. However there are some alternative health systems in Cuba China Costa Rica Malaysia Sri Lanka Rwanda Venezuela and Thailand. Since 2002 there is Universal Health Care (UHC) coverage in Thailand for all people without any charge and now 77 per cent of all hospital beds there are in public sector. Cuba has a sustained drive to ensure cataract operation of all old people at public facilities. There is equitable health service delivery with regulations like three years of compulsory rural service for doctors and nurses and a radical shift in funding away from urban hospitals to primary health care across Thailand and Cuba. Health expenditure in Thailand increased from 1.7 per cent of GDP in 2001 to 2.7 per cent in 2008 higher than that in India. There are 9.4 doctors in Malaysia 11.5 doctors in the Phillipines 12.2 doctors in Vietnam and 18.3 doctors in Singapore for every 10000 population better than India (only 7 doctors for 10000 population).
