New Agenda for Chennai Health Meeting

Note: This is the revised agenda for the 24th December meeting in Chennai on public health in India. All suggestions from participants are welcome regarding the agenda.

9-9.15 AM Presentation on ‘Why the Indian Health Front?’
Some ideas…
• Not to compete with any existing organizations but to add more hands to the huge tasks ahead on public health
• To put public health on the political agenda
• To rebuild traditions of solidarity, cooperation and compassion
• To network all those interested in working on these objectives

9.15 – 10.00 Discussion/Introductions
10.00-10.30 Tea/Coffee Break
10.30-10.45 Common Minimum Agenda on Health
Some ideas…
• Universal Health Insurance
• Higher budget allocations for health
• Nutrition for All
• Energy for All
• Water for All
• Sanitation for All
• Employment for All
• Disaster Response
• Organizing Healthcare Workers

10.45- 11.45 Discussion
11.45– 12.00 International Experiences Cuba and Venezuela
12.00- 12.15 International Experiences USA
12.15- 01.00 Discussion
01.00 - 01.30 LUNCH BREAK
01.30 - 01.45 Bant Singh Video (5 minutes) Case Study
01.45 -02.30 Jan Swasthya Abhiyan and ‘Politics of Health and Health of Politics’
Reservations and Medical Education
Disasters in the Indian context

02.30- 03.00 Discussion
03.00 03.15 Proposed Principles of IHF
Some ideas….
• Humanitarian Approach
• Citizens Participation
• Against discrimination
• No direct funding of work

03.15 - 04.00 Discussion
04.00-04.45 Campaigns
Some ideas…
• Universal Health Insurance on all Party Manifestos
• Solidarity with junior doctors and nurses
• Setting up local level health committees
• Impact of food prices on nutrition
• Safe Drinking Water for all Citizens
• Sanitation for All
• How to use RTI Act for public health work?

04.45- 05.30 What Next after Chennai Meeting?
How to keep in touch?
Website and Newsletter

How to Improve Access to Healthcare

An interesting viewpoint on new ways of improving access to healthcare from Dr U.N.Nair, Professor of Rehabilitation Medicine, Annamalai University. He can be reached at unnair@yahoo.com

“Health crisis affects a large number of people in the third world. It is now fairly accepted that for people who pay from pocket the expenses on medical care tend to become impoverished with each episode of health crises. And for poor people and lower middle class, the chances of attracting diseases tend to remain high due to situational and environmental impacts.

The typically understood model of health care is the medical care of diseases model, where professional time and resources are spent on finding diagnoses, planning high cost treatments and tertiary care referrals. Even Governments and policy makers have this in mind when they sit down to spend the health allocation. With the advent of super specialty and corporate hospitals and medical tourism a situation has come where medical treatment is no longer affordable to one who has to pay from one’s pocket.
Alternative strategies are surely thought of by health workers and NGOs. Most of the evolving models seek to establish community level health facilities that subsidize cost as well as economize expenses on diagnostic procedures (eg., investigations). Or they concentrate on sensitizing the public health system.

While these are essential initiatives that are necessary other models ought to be thought of if they are sustainable:
1) Participatory cost reduction steps in medical care at government and private sector health institutions
2) Protocol based investigations and treatment planning for patients who pay from pocket
3) Free and unrestricted access to medical documents to consumers
4) Quality assurance reforms in health care institutions especially the primary and secondary level centres where poorer patients seek care from

These four areas are to covered as a single package and should include both public and private health institutions. This might be thought of as a useful addition to the existing models of community health initiatives.”

Hospitals, profitability and patient welfare

As India continues its march towards expansion of private, for-profit, tertiary healthcare institutions, this article by Kurt D. Grote, Edward H. Levine, and Paul D. Mango in the McKinsey Quarterly is likely to be of interest (you would need to fill in a registration form to enter the site).

The analysis in this piece about the future of US Hospitals in the 21st century explains the philosophy that guides healthcare institutions in scenarios other than those based on human welfare and right to medical care (which are accepted and outlined in international covenants).

There is worry expressed in the article that hospitals in the US are having to cater to people who may not be solvent and to others whose bills are indirectly paid by hard-bargaining governments that may not care much about the hospital's profits. Their competitiveness has also been compromised, we are told to believe, because philanthropists have been giving money (and thus blunted profit-generating skills) and employers insured employees (rather than allow the hospitals to come up with 'innovations' that skim off funds from the wealthier among them).

In this analysis, patients are "health care consumers" and the challenge before hospitals is to reinvent themselves on the model of leading retailers, who know what the customers want and are willing to provide it!

If this is the vision that is going to guide the McKinsey-inspired Public Health Foundation of India, then we know what to expect.