There is always a light

There is always a light
Don't be afraid if you are alone or surrounded by darkness. In some part of the world, the day has just begun. There is a always a light waiting for you to find your way to touch its radiance.

Tuesday, November 17, 2009

Life-Substance, Anyone?

By Arun Kumbhat
Gurgaon, India

Healthcare costs predate the subprimes and the metltdown in the context of socio-economic debates worldwide and also the politics of mature economies.
 Healthcare costs, in say for example India, are about a sixth of what they are in the US. We are all willy-nilly aware of that.
 Let us peel the onion a bit.
 Drug costs, which you and I would assume are a major contributor to the Health Cost burden of these economies. Well here’s news drug costs contribute about 15% to the US Healthcare costs and about two- thirds in India!!!!! Yes, you heard that right- INCLUDING the research costs and the gargantuan cost of developing and delivering new drugs.
 The drug industry is under pressure for its Shenanigans worldwide (you did NOT hear me say – wrongly so) and more so in the US and Europe and price control is wielded as a stick by these governments with much fanfare and great public serves-them-right mirth!
 Sixty per cent of the medicines consumed and prescribed in the US are now Generics – Talk about shaving costs! The pricing of generics has always been a rapid downward spiral.
 So where do the rest of the 85% of the costs cascade from?
The answers are obvious. Medical and Healthcare delivery professionals and insurance costs.
 Peel some more?
 Outside the lawyers, it is generally true that Doctors are the highest income group in these mature (mostly a euphemism for dated) economies. Insurance companies with cashless compensation have a great deal to do with their compensation levels and prescribing habits in contrast to what happens in ‘pushcart’ economies like India. Add to this what the drug industry forks out by way of Doctor-Indulgence or promotion – your preference of nomenclature is gladly indulged. So which hands are really cleaning up the cookie jar?
 Again, the Indian patient in 80% or more cases pays for his healthcare from his own pocket. The costs are perhaps also lowered by a mix of traditional systems, home remedies playing a role in making healthcare affordable and accessible. Again 20% of the healthcare is delivered by the public system and 80% by private channels. Cost Plus system of pricing and the resulting tempering of aspirations keeps delivery costs low.
 Contrast this with lifestyles and incomes in the Healthcare Delivery systems in the mature economies and you pretty much have an understanding of the 85% slice and its appropriation.
 Did I hear the word 'Socialism' hurled somewhere?
 Peel a little more.
 What does really drive compensation levels anywhere ? – Lifestyle Aspirations is my call.
 What is yours?
 Simpler, humbler lives anyone?
 Life-Style  or Life-Substance? Look within.
 And we haven’t even discussed the impact of life style diseases and its contribution to the disease burden, with its consequences and costs yet! Oh yes, there is then also the life style - environment equation!

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