Dear Shanta,
I feel honored to find space in your blog. There is no disagreement between us. Sorry, my article was not clear enough and led to confusion. When I recommended increasing the number of MBBS, I had in mind that they will work as private practitioners and not add to the rolls of absentee providers in the public sector. Foremost in my mind was Karnataka which has added medical colleges faster than any other state, expanding the supply of doctors in the private sector. The result has been the availability of medical services at prices well below most other states.
Some five years ago, I fell down in Bangalore and was taken to a private hospital by my host institution ISEC. I was first examined by a physician, given an anti-tetanus shot, had x-rays taken of knee and arm, and then seen by an orthopedist. The orthopedist explained using the x-ray, just as in the U.S., that I had a hairline fracture in the arm. They then gave me an arm sling and a bunch of pain killers. All that cost just Rs. 600 ($15 at the current exchange rate)! If this had happened in Jaipur, my hometown, the cost would have been at least four times. Unsurprisingly, Rajasthan has had no more than two medical colleges added in the last twenty years!
Arvind
Tue, 02/26/2008 - 04:22 There is merit in the diagnosis of what ails the health sector in India. However, iam doubtful to what extent the presciptions work for the following reasons: (1) Vast areas of India do not have private sector presence, entire NE, and (except some towns) UP,Bihar,MP,Jharkhand,Chattisgarh.Where would the poor go ? (2)More number of Nursing/pharmacy colleges will be more useful than medical colleges.Junior doctors went on strike when asked to work in rural areas.(3)Private health care is very costly in Delhi- which begs issues of regulation (4)The existing structure of CHCs,PHCs are not suitable in many parts of the country, given the terrain and access.
Mon, 02/18/2008 - 20:19 As a former Banglorean, I couldn't agree more with Mr Arvind Panagariya's comments about the plethora of medical colleges and availability of low cost medical services in that silicon city. However India's rural areas suffer, not only because of the dearth of practitioners there, but because the Indian government and the private medical institutions who churn out medical graduates do not include,nor enforce a community rotation for a said number of years in these rural communities. Today in the US,there are many rural communities where one might find Physician's Assistants providing the same kind of quality care that an MD does. Given this, it might be time for the Indian government to look at introducing Physicians Assistant programs (cheaper than a Medical Degree) to fill in the gaps so that the poor too can access quality medical care at a low cost. G. Rao