Wednesday March 20, 2019

Obamacare: Lessons Indian healthcare can imbibe

0
//

health-621353_640By Dr. J.K. Bhutani

The healthcare system of any country, be it US or India essentially has three key players, viz. Providers, Payers and the Public Health. The successive governments have had many successes inter playing these keys and such actions have led to many improvements in the US healthcare delivery systems. But much work still remains to be done. The private and public insurance reforms and other interventions apart, one in six Americans still does not have insurance cover and thus, cannot access the best health care.

The infant mortality, the life expectancy, other health parameters and quality of healthcare have improved over the years but the cost escalation has increased to disturbing levels too. The US health care costs are disturbingly high, so much so that the providers are sometimes labeled as ‘Working just for commerce and profits unlike the forefathers who worked for serving the humanity’.

From Harry Truman shortly after World War II, to Barack Obama now, many presidents have tried to reform the US healthcare system. The most laudable and controversial has been ‘The Patient Protection and Affordable Care Act of 2010’ or ACA, which has attempted to recognize and support the key role of Public Health in the healthcare system. The US Supreme Court recently upheld the nationwide availability of tax subsidies for the implementation of President Barack Obama’s signature healthcare law… Obamacare (Affordable Care Act – 2010).

Of the four components of any health delivery system (Patients, providers, payers, and public health), The Affordable Care Act attempts for more funding and key role of Public Health. The ACA shall reduce ‘out of pocket’ expenses and bring all preventative care under insurance… subsides by the Federal Government. All developing economies including India, need to learn and strengthen the Public Health institutions from the greedy corporates and their ‘Target-business’ models of health delivery for hospitals and service providers.

Other issues which need attention in US and India are –

1. The American health system with a provision of ‘cutting edge technology’, ‘micro-specialization’ and the ‘best evidence-based practice state of the art medicine’, is the role model for the whole world. The costs are more essentially because of the excessive reliance on the investigative ‘work up’ for fear of litigation. The bulk of the common diseases which have self-limiting course are also worked up unnecessarily.

The primary care strengthening should address this and some strategy can be evolved and legislated to keep common day-to-diseases out of the ambit of litigation. This single step can reduce the cost of nearly 80 percent of the diseases which have an insignificant or self-limiting course.

2. The onus of responsibility exclusively on the Federal Government though sounds responsible but is more of a populist measure for winning the elections in democratic set ups. The onus of the physical and mental health of the family and children should be the responsibility of the parents and the role of the governments should be to improve the social component of health like providing good civil conditions and good environment including water, housing etc.

3. The Insurance concept makes us all reckless with our health and should not be owned completely by the governments and should be shared by the people especially for the Metabolic disorders and Lifestyle diseases like Obesity, Hypertension, Diabetes, Trauma, Alcoholism, Drug Abuse, etc. for which the person himself should pay and Federal Government should only have affirmative role in such diseases. These should be out of ambit of Medicare or Medicaid and insurance subsidies….!

JK1

Dr J.K.Bhutani MD is a protagonist of preventive and promotive health care based on austere biology and facilitating self-healing powers of human organism.
You can follow him at https://twitter.com/drjkbhutani

Next Story

Beware! Sipping Hot Tea Raises Risk of Esophageal Cancer

Esophageal cancer is the sixth most common cancer in India and eighth most globally. It affects more men than women.

0
tea
Scalding water irritates the lining of the mouth and throat which can fuel tumours, scientists believe. Pixabay

Love to drink your tea piping hot? Beware, it could raise the risk of esophageal cancer, finds a study.

The study showed that risk of esophageal cancer more than doubled among those who regularly drank tea at 75 degrees Celsius

However, waiting for at least four minutes before drinking a cup of freshly boiled tea can reduce the risk of the cancer arising from the oesophagus — the food pipe that runs between the throat and the stomach.

“Many people enjoy drinking tea, coffee, or other hot beverages. However, according to our report, drinking very hot tea can increase the risk of esophageal cancer, and it is therefore advisable to wait until hot beverages cool down before drinking,” said lead author Farhad Islami of the American Cancer Society.

tea
The study showed that risk of esophageal cancer more than doubled among those who regularly drank tea at 75 degrees Celsius. Pixabay

The study, published in the International Journal of Cancer, involved 50,045 individuals aged 40 to 75 years.

Drinking 700 ml per day of tea or more at a higher temperature (60 degrees Celsius or higher) was associated with a 90 per cent higher risk of esophageal cancer, the researchers said.

The results could also be extended to coffee, hot chocolate or other hot beverages.

Esophageal cancer is the sixth most common cancer in India and eighth most globally. It affects more men than women.

coffee

The results could also be extended to coffee, hot chocolate or other hot beverages. pixabay

Also Read: All New Gaming Platform! Google Launches Cloud Gaming Service Stadia
In 2016, the World Health Organisation (WHO) had warned of the cancer risk associated with drinks above 65 degrees Celsius.

Scalding water irritates the lining of the mouth and throat which can fuel tumours, scientists believe. (IANS)