Despite the government’s best intentions to provide the poor and the underserved with health insurance, out-of-pocket expenditure on hospital bills and medicines remains one of the top reasons for pushing a family into debt. In this personal account, a practising doctor finds how inability to pay for his own profession’s services and complicating the lives of people he meets:
This happened one evening when I visited my favourite salon. It was evening, and there was no rush. Suraj — who works there — realised I am a doctor and directed a very profound question my way.
He said: “Doctor, father suffered from gallstones, which were complicated by an infection; we had to get him to have an emergency surgery. He sighed and continued, “The cost of treatment was around 50,000 rupees. Consider my situation: As a barber, I earn barely 20,000 rupees a month, and suddenly, I had to pay two-anda- half times my monthly income in one shot, because the situation was critical. I am the sole earning member of my family. Tel me, how can I afford treatment?”
It was really heart-breaking to listen to his story. It made me realise that all the insurance schemes of the government are just not reaching common working citizen, who still has to pay out of his precious savings to save his father’s life.
There is a poor fellow who lives around the corner of a lane. I decided that I just had to make him aware about the various available health insurance schemes. He rightly said: “When we the poor, struggle financially, we really don’t realize the depth of how much we have actually fallen. The debt is so huge that even working hard is not enough to restore ourselves to prosperity.”
He is sincere and dedicated to his work. I felt really sad that such common, but unexpected incidents could leave such a large financial impact in their wake. Not only did he have to pay out of his pocket, he also had to borrow money from the bank as a loan to pay healthcare bills, and lost even more money by paying interest on EMIs.
Suppose he took a personal loan of `50,000 at 11% interest. His EMI will roughly be 1100 rupees for five years, and his effective monthly salary will be reduced from 20,000 to19000 — a 5% cut of an already low income.
Should such medical catastrophes keep on happening every couple of years, then at the end of five years, his effective income will reduce even more.
It is really hard to understand the microeconomics of middleclass family budgets. but at the same time, it is a cautionary tale for many of us who are having similar situations to face on many occasions!
Effective management of finances is key to success. But at the same time minimizing expenditure is saving. There is a huge unmet need for management of finances for every human being and there is need for proper infrastructure like facilities for training and educating in these areas where there is a lot of ignorance.
Dr Dhruv Mamtora
Consultant Microbiologist and Infection Control Officer,
S.L. Raheja Hospital, A Fortis associate, Mumbai
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Healthcare Hygiene
Healthcare centres currently use antibacterial cleaning solutions and mopping on a regular basis to maintain hygiene, and the NHS guidelines require that surfaces throughout hospitals should be “visibly clean”. Whilst mopping and scrubbing can increase hygiene, it may be limited in its effectiveness without some supporting factors which are often neglected. Read on for some useful tips on making hospitals and healthcare centres more hygienic.
Boosting hand hygiene: Whilst hand hygiene is strictly enforced amongst healthcare professionals such as doctors and surgeons, hand hygiene amongst other members of staff and patients is not properly regulated. Studies are showing that a lack of hand hygiene is detrimental to hospital hygiene, and the transfer of micro-organisms between hands within hospitals is a major factor in the spread of disease. One way to prevent this is to increase the number of handwashing facilities, such as hand sanitisers and wash basins. These can be placed strategically at entrances and in waiting rooms, presenting all patients and staff with the option to sanitise their hands quickly and easily as they pass through.
Hygiene education and awareness: Whilst introducing these handwashing stations increases the availability of ways to improve hand hygiene, this impact will be minimal if these stations are not widely used. Therefore, hygiene education and awareness must be promoted throughout the hospital building through posters, signs, messages on TV screens in waiting rooms and more. It’s important that these messages are engaging, bold and convey information quickly in the fast-paced hospital environment. Place these informative messages throughout the building, but particularly next to handwashing stations in order to promote their use.
— Cleanzine
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