You might have read about how a PG seat in Radiology was sold for 1.75 crores in Navi Mumbai. Tell me, what kind of commitment can one expect towards his profession when a medical student has to pay that kind of money, except his commitment to recover the cost of his degree?
MBBS seats are sold for as much as 40-50 lakhs or more in private colleges throughout the country. Is there any wonder then that the students who manage to buy them also manage to fudge their marks to pass the exams for a few lakh rupees more? And once they get their degrees these ‘doctors’ happily play with the lives of the patients. Cases of negligence, wrong diagnosis and medication abound today. Recently one of my friends was diagnosed with ovarian cancer and put on drugs for the same till a second and third opinions proved the original one wrong. Who is going to pay for the damage caused by the highly potent medicines? And what about the mental agony? Perhaps the doctor was trying to recover the cost of his costly diagnostic equipment.
Education had become a business long ago. All one needs is to start a school or college and make enough money for several generations to come. And so today we have everyone and their doorposts starting an ‘education society’ or ‘education trust’ and fill them with their family and friends. The buildings are grand, the campuses impressive and the education just about adequate. States like Maharashtra, Karnataka and Tamil Nadu boast of engineering colleges by the hundreds!
But when it comes to medical colleges, the scenario has worsened. It is still a case of capitation fees, which is transacted under the table of course. Government medical colleges have not increased in number nor have they increased their seats commensurate with the increase in the number of students. As Dr. Devi Shetty, founder of Narayana Hrudayalaya and former member of the Medical Council of India points out, ‘We need at least 100 government medical colleges immediately. There are so many children from rural areas who want to become doctors but can’t afford to pay the fees of private medical colleges.’ Another advantage is that the selection can be done on merit, and not based on their capacity to pay capitation fee.’
Dr.Shetty opines that when a poor student is given a chance, he will have more commitment towards his profession, for he has felt the pangs of need. ‘Why should you stop students from aspiring to become doctors? Give them a chance at least!’ he urges.
It is natural that when one has to pay tens of lakhs or even crores for a medical seat, one can’t expect the doctors to be dedicated to their profession who will work for the poor and needy. Is it any wonder then that today no doctor wants to work in the rural areas and even doctors in government hospitals are running clinics on the sly to make more money.
We have something called ‘medical tourism’, where we have patients coming from developing and even developed countries for costly treatment including cardiac surgeries because it costs a fraction of what it does in developed countries. Isn’t it ironical that we have so few doctors that according to one study, there is only one doctor for nearly 2000 people in India and yet we can spare them for medical tourism?
Today only those who have money can afford quality health care in India. While this is true of private hospitals, it is power that plays a role when it comes to the premier government medical institutions like the AIIMS or the PGI. If you are a senior bureaucrat or minister or even a petty politician, you can rest assured that you will get the best possible treatment in these premier institutions. Else, you have to languish in filthy wards and suffer the indifference of the staff including the attendants whose hands don’t work unless their palms are well greased.
There is nothing like uniform treatment in hospitals – whether government or private. While charging more for those who can afford a special ward with extra facilities is fine, but giving second-grade treatment to someone in a general ward is not acceptable but is the norm. As it is, a middle-class family with a single earning member goes into heavy debts after any hospitalization and if it is a life-saving one like cardiac surgery or kidney transplant, then the situation is worse. I know of one family where the money saved to ‘buy’ a seat for the son was spent on hospital costs for the father.
Even when there is medical insurance, the costs don’t cover everything. I remember having to pay nearly 50% of the hospitalization charges when I had undergone a a major surgery several years ago, despite having medical cover. There are so many clauses and conditions in the policy that one ends up paying huge bills when getting discharged because it does not cover this, that and more — and even after discharge when one goes for reviews and follow ups.
All the mandatory quota of free beds in private hospitals is a big eye-wash since the other costs are so exorbitant that the patient can’t afford to pay even a fraction of it. The medicines, the nursing charges, the other facilities…The Delhi HC has ordered all the premier hospitals to give 25% OPD treatment and 10% in-patient treatment free of cost, but the beds are lying vacant as the hospitals are not willing to comply, arguing that they ‘would go bankrupt,’ if they did.
Are the hospital charges high because it has become a business like other businesses and runs purely on profit? Even hole-in-the-wall private nursing homes and clinics often have expensive diagnostic equipment to attract gullible patients who are made to undergo superfluous tests and investigations. How else would the practitioners recover the cost of the equipment and the price they paid for their medical seat?
This is similar to reserving seats for poor students in public schools in the country. How can a slum-dweller’s child compete with an industrialist’s child when it comes to meeting the other charges levied by the school in addition to the tuition fees, which has been waived off magnanimously? Is the school giving the uniforms, books and stationery free of cost? So where does that leave the poor student?
A couple of decades ago, the number of seats in engineering colleges were limited and many of these institutions gave admission based on the ‘capitation fee’ system. Today there are so many engineering colleges countrywide that even your doodhwala might have one and give your child admission if you paid the fees! True, it might not be the best college, but that hardly matters because the job market is on the upswing and one is assured of a job anyway. Isn’t that’s a good thing?
Likewise, if we have more medical colleges, we can create more doctors, which will reduce the doctor patient ratio and thereby reduce the medical costs too. The need of the hour then is to create more medical seats with affordable fees to enable students from smaller towns and rural areas to get admission. Coming from deprived backgrounds would also make them more committed towards their profession, don’t you agree?
Today, when everything can be bought for a price, is it any wonder that we ‘buy’ education, including life-saving ones like a medical seat/degree?
The words of the season being democracy and constitution do I hear someone say that in a democracy it is unconstitutional to interfere with someone’s fundamental right to sell or buy a seat?
I would love to hear your views on this.