A healthcare system that favors treatment over results is not really focused on the well-being of patients

It is very telling that 80% of deaths in India from Covid have occurred in people already suffering from noncommunicable diseases (NCDs) like diabetes. Currently, 70 million Indians are living with diabetes, but that number is expected to exceed 100 million by 2030, and another 200 million are living with prediabetes and its risk factors and other chronic diseases according to the WHO.

The most alarming observation is that while noncommunicable diseases are present in people aged 55 or over in many developed countries, their onset in India is observed a decade earlier (> = 45 years).

The World Economic Forum has suggested that India suffered an economic loss of $ 4.6 trillion due to NTMs between 2012-30. How can we as a nation avoid such ruin? First we need to know how the current and traditional health care model provides care to us.

End conflicts of interest

There is a charge for the service, rewarding the amount of service provided. This prompts caregivers and systems to increase the number of visits, procedures, diagnoses, and drug treatments, which may not necessarily be in line with an individual’s health and well-being.

We have financial advisers, why not health officials?

This is demonstrated by a recent study in Madhya Pradesh in which 10% of the population was using inappropriate drugs at some point. This number has climbed to almost 50% for those over 65.

There is also a lack of transparency regarding the results; with poorly defined or non-existent metrics to analyze them even in place. For example, do you know the results of surgeries performed in the hospital where you want to have the operation or that of your relative?

Encourage disease prevention

The current system is not about preventing all of us from contracting the disease, but about treating us when we have an illness. There is of course a place for that, as we will inevitably get sick and need treatment at some point, but how do you create a system that is incentivized to try to keep us healthy and happy? A system that could prevent millions of people from getting diabetes?

This is where “value-based health care” comes in. It is a quality-based system in which fees are paid for the outcome of treatment or even for disease prevention.

Control unnecessary costs

Patients and individuals are kept at the center of care, their well-being aligned with business results, avoiding overtreatment or overdiagnosis. Reimbursements are linked to compliance with specific performance criteria, such as the results obtained by patients or consumers after treatment.

India’s healthcare system is not much different from that of the United States and in 2009 the United States was found to spend an additional 33% on unnecessary health costs such as unnecessary services, excessive administrative costs and inefficient systems.

Imagine proactive doctors

Currently, the system is very responsive. You only interact with doctors and the health care system when you have a problem or are sick. But imagine if, along with a doctor, you have an entire healthcare team proactively looking after your health and wellness, to help you achieve your goals and be the best version of yourself.

When it comes to shopping, we have shopping assistants and smart algorithms to help us identify which clothes we would like to buy. When organizing a wedding, we have a wedding planner to help us put all the elements together. We even have bank managers and staff to help us manage our finances.

So why in health do you have to navigate such a fragmented system that you are unsure of and have to consider if something is in your best interest and seek a second opinion?

Integrate results and assurance

Imagine having a team helping you with integrated care, providing the right advice every step of the way, ensuring you get the best management options in the most cost effective way.

Now imagine this kind of system built into your insurance, which during Covid we have seen can be critical. The financial incentive for this healthcare system is to improve the health of its clients as its payments are directly linked to their health outcomes.

Say goodbye to the fragmented healthcare system. There will be standardized outcomes and costs of care. The best performing organizations will get the best payouts, ideally from an insurer.

But if we stay on the current path, we could see the number of chronically ill people in India increase by an additional 200 million over the next 9 years and then (try to) treat them. Instead of living with disease, let’s live healthy.



The opinions expressed above are those of the author.


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