While we boast of having one of the world’s largest trained manpower pools in health care sector and a world-class pharmaceutical industry, there are many problems afflicting our health care system. Three critical issues standout. First, most people do not have access to health care of acceptable standards. Second, whatever is available is unaffordable to the bulk of our population. And third, there is absolute lack of accountability. Let us examine the issue of lack of accountability.

A few days ago, the government of AP declared their goal of starting 40 medical colleges in the state. Certainly society does need more and better health personnel. But mere increase in doctors’ strength does not help.

Recently a friend’s son was hit by a bout of fever. When my friend called me and explained the symptoms, I have immediately advised to start him on a course of anti malarial medicine and the kid recovered in no time. The whole episode costed my friend very little – no hospitalization, no trauma associated with long illness or anything of such sort.

Recently, a doctor friend of mine in Hyderabad commented that too many people were approaching him with respiratory disorders. This can be partly explained by the winter cold. But in a substantial measure our illnesses are man-made. Here are some facts for you. A study by a reputed public health journal pointed out that 30-50 % of twin cities population is suffering from allergy, asthma and other respiratory disorders. Other studies also pointed out that almost 25% of school children in the city are suffering from asthma and other respiratory disorders such as bronchitis.

While the Kumbakonam tragedy is yet to fade away from our memory, the heartrending saga of kids with heart aliments has come to stalk our collective conscience. Hundreds of paediatric cardiac patients were paraded on the streets of Hyderabad seeking surgical treatment, and one of them died in front of television cameras. The well-meaning media and activists are focusing on the human drama and pathos and pressurizing the government to make allocations. Hospitals are hard-put to cope with the patient-load. In all this, the real issues are ignored to the detriment of the poor.

The UPA government’s National Common Minimum Programme advocates a national health insurance scheme to help poor tide over the economic crises resulting from costs of illhealth. Is such insurance a viable option? This requires detailed examination, and a serious national debate. Several states are toying with such an idea of health insurance in recent months. Any hasty decisions without careful evaluation of costs and benefits will land the nation in a potentially no-win situation.

align="left">In many ways the 2004 Lok Sabha election verdict is an expression of discontent by the poor and dispossessed. But the verdicts are not against economic reform; they are for a more inclusive growth process that meets the aspirations and basic needs of the underprivileged.

One of the challenges facing us today is providing reasonable quality healthcare to all people, irrespective of birth, caste, status and wealth. We are one of the most poorly served countries in terms of health care. And yet we have an impressive infrastructure of medical institutions.