Past, Present and the Future

Anand October 15th, 2009

In the recent posts I have talked about health care comparisons, and its current state in India. Now, let us take a look at how Health Care and quality of life has fared in China.

China is a unique country with almost 1.2b people being governed by a communist government which uses capitalistic instruments to steer and grow their economy. Health Care is a great example where the world can learn from China’s early successes. The goal to start out was to provide care to everyone and make the most use of the limited health care personnel. The focus was more on preventive care rather then curative and one of the stats which show that this really worked is that the life expectancy grew from 32 years in 1950 to 69 years in 1985.

The structure was deliberately chosen and designed to be three tiered one so as to make maximum use of the resources. The first tier was village medical centers to provide preventive and primary care services. They had an average of 2 doctors per 1000 people.

The next tier was the township health centers with mode advanced clinics and facilities but the doctors were not still highly qualified. These two tiers made up the complete rural health care system and was the backbone.

The final tier was the one in urban areas and was referred for the most seriously ill cases. Then there was District and Municipal hospitals which had more advanced professionals who could handle the most serious cases.

This system worked pretty effectively for a very long time but then the economy started growing once the markets were opened up and foreign investment started coming in. As part of the market reforms in 1978, Deng Xiaoping privatized large chunks of the health care system. The forces and decisions which made the high trajectory growth possible undermined the quality of care in the rural areas.

As the economy grew, people became more ambitious and wanted a better level of care so they started to bypass the first two rural tiers and started going to the doctors and hospitals in urban areas as they had to bear almost half of the cost. This led to the decline in number of the health care professionals serving the rural areas which in turn led to the overall decline and increasing prices.

The privatization brought in advanced technologies and new drugs but everything comes at a price and it was the same case here too where the inequalities in the distribution of the health care grew and though it is not at a verge of collapse, the situation mirrors the dilemma we all have in front of us?

What can we do to ensure that people start trusting the health care systems again? What can we do to empower the doctors and the patients and make sure that the focus is on the right parties and not insurers and health providers?

eZdia is trying to just do that. The focus and the intent is to provide a platform where the interaction between doctors and patients can happen in a secure and a safe manner without the intervention of the big companies.

The focus is to use the experience from the past and encourage people to use preventive medicine rather than going to a doctor after contracting an illness. The studies have shown that almost 60% of the illnesses and conditions could have been avoided if proper care and preventive measure have been taken earlier.

eZdia gives you a platform to do just that. The great thinkers and policy makers knew that to succeed and improve the health care for the masses, the focus has to be on creating a vibrant grass roots community where people have easy access to information and preventive measures. China and India from 1950’s to 1980’s are good examples that this worked before the privatization came along.

We will talk more on the details of how eZdia works in the next set of posts.

Tags: China, Doctors, Health Care, Healthcare, hospitals, India, Patients, preventive medicine

• Advice , Doctors , Entrpreneurship , Health Care , Health Care , Hospitasls , India , Knowledge Platform , Nurses , Patients , experts , ezdia
• Comments(2)

Anand October 11th, 2009

Lets start with some facts and slides on the current Healthcare market in India

Healthcare Infrastructure:

The Indian healthcare industry is growing at a rapid pace and is expected to become a US$280 billion industry by 2022. The Indian healthcare market is currently estimated at US$35 billion and is expected to reach over US$75 billion by 2012 and US$150 billion by 2017. According to the Investment Commission of India the healthcare sector has experienced phenomenal growth of 12 percent per annum in the last 4 years. Rising income levels, a growing elderly population, and increasing awareness are all factors that are driving this growth. In addition, changing demographics, disease profiles and the shift from chronic to lifestyle diseases in the country has led to increased spending on healthcare delivery.

Looking at the rise and the potential, people might be lulled into thinking that the quality of life is increasing at a rapid clip but what we forget is the size of the population and concentration of pockets of excellence.

Approximately one million people, mostly women and children, die in India each year due to inadequate healthcare. 700 million people have no access to specialist care and 80% of specialists live in urban areas. In addition to poor infrastructure India faces a shortage of trained medical personal especially in rural areas where access to care is altogether limited.

According to WHO statistics there are over 250 medical colleges in the modern system of medicine and over 400 in the Indian system of medicine and homeopathy (ISM&H). India produces over 250,000 doctors annually in the modern system of medicine and a similar number of ISM&H practitioners, nurses and para professionals.

India faces a huge need gap in terms of availability of number of hospital beds per 1000 population. With a world average of 3.96 hospital beds per 1000 population India stands just a little over 0.7 hospital beds per 1000 population. Moreover, India faces a shortage of doctors, nurses and paramedics that are needed to propel the growing healthcare industry.

As incomes rise and the number of available financing options in terms of health insurance policies increase, consumers become more and more engaged in making informed decisions about their health and are well aware of the costs associated with those decisions. In order to remain competitive, healthcare providers are now not only looking at improving operational efficiency but are also looking at ways of enhancing patient experience overall.

The overall figures might be telling a rosy story but the Devil is in the Details. The following charts show the story in numbers and drivers in the healthcare delivery.

Demand and Supply in India

Current Stats

Drivers in Healthcare

Demographics

Urban vs Rural

Major Players

Now that we have seen the details, how can we help as Indian Citizens and help in improving the quality of health care in a way which helps us and our fellow citizens.

Do we wait for the government to pass policy measure, make investments, and open up regulations? Do we wait for private individuals and organizations to open new hospitals, hire new doctors, or create new delivery mechanisms?

Cannot we do something which will help all of us in reaching our goal of universal health care faster and in a more effective manner?

We all tout about our technology prowess with some of the greatest minds in the various fields of technology. So, what happened to us? Why are we waiting for some one to take the baton and lead us?

We at ezdia have created a online democratic platform which will put the focus on the two major players in this whole arena Doctors and Patients. We have taken the whole focus away from this relationship which makes the high quality care possible. But, ezdia provides this access anywhere, anytime using the most flexible information sharing medium the world has ever seen. We don’t have to wait for physicians to go to rural areas once every three months, instead we can talk to the physicians of our choosing anywhere, anytime?

I will talk more about how ezdia works and how it will help you to resolve your problems and in the process increase the quality of care for the whole country, our country.

Tags: Doctors, Healthcare, India, Nurses, Patients, Physicians, WHO

• Advice , Doctors , Entrpreneurship , Health Care , India , Knowledge Platform , New Media , Nurses , Patients , WHO , experts , ezdia
• Comments(17)

Anand October 8th, 2009

Today, everybody is talking about health care. Governments around the world are taking notice of the rising costs and dissatisfaction among their electorates with the current system.

So, why is this discussion going on and how can we “the common man” can help in creating a more robust and a flexible system in which everyone participates and contributes to the well being of their fellow beings?

The different models used in different countries are now being hotly discussed for their pros and cons but do we really know how the future will look like?

How do we really know what is good for us?

Let us try to compare some of the different models in practice today. We will then talk about how we as individuals can help in creating a healthy health care system which caters to people and not corporations.

Comparison by Countries:

The below table shows some comparative numbers by countries:

The comparison highlights some really interesting facts and shows us how to measure the current state of our health care systems and what we need to focus on for the future.

So, how do we make a decision as to what model is the best among these and is more effective? Does it really matter whether we chose one model among these and then apply it universally?

Shouldn’t we as individuals get the freedom to choose what works for us and then pay for the services we choose? Should it matter where are we getting the advice from? Should the government regulate how we choose our doctors, physicians, health care providers, insurers etc?

How Internet is changing the landscape and where we as individuals fit in.

Internet since its inception has changed the way people communicate with each other. It has opened the doors to the world and has shrunk the distances. There have been break through firms and business models like Amazon, EBay, LinkedIn, Facebook, MySpace etc which have changed the way how people do business with each other. It has leveled the playing field by reducing the barriers to entry and at the same time has fostered the culture of innovation by giving the freedom to individuals to get their ideas in front of the world any time, any where at no cost.

One such innovation is enabling Personal or Micro Sourcing on the internet platform. This is not a new concept by any stretch as it has been in practice since the Indus Valley, Mayans, and other older civilizations. It was one of the ways to facilitate local trade but till the advent of internet was practiced on a small scale.

Internet has given wings to the micro sourcing area by opening the access to the world at the touch of a button. I happen to know that a very good friend of my colleague at eZdia, Sachin is working on a research paper on this very topic to gain deeper insights on how people make decision on the internet and real life when it comes to trading at an individual level.

Now, let’s see what happens when we apply the micro sourcing phenomenon and the wisdom of crowds to the Health Care area. We know that the heath care systems today are broken, inefficient, and haven’t upgraded to meet the needs of today. We also know that governments have been trying for decades to overhaul the health care systems. But, changing complex systems, and bringing change is difficult, time consuming and incredibly frustrating.

So, how can we help to bring this change?

I talked earlier about breakthrough firms successfully using internet based models. Let us take a deeper look into some of these firms who have started to use the concept of micro sourcing and are providing the online platforms to facilitate this trade.

A comparison between these firms can be found on my very good friend and colleague, Vikas’s blog (http://referencedesigner.com/blog/tag/health/).

The idea is to provide information and freedom to people looking for advice at a minimal cost without encountering the hurdles of the bureaucratic health care systems. Take a peek at ezdia (www.ezdia.com) where you will find hundreds of registered experts and physicians by their areas of expertise. You can search for your question or search for the expert by area on ezdia and both of these ways will lead you to a live person regardless of where is he located. Once you have the expert identified, you can choose to talk to him live through chat or phone (this feature is coming soon in October’ 09) and pay only for the services you take.

This is not say that the formal health care systems will go away or vanish in thin air. They do have a great role to play from Pharmaceuticals to Health Insurance providers to Hospitals to Nurses to Doctors. But, at the same time we can and should leverage the wisdom of people and there are almost 4billion of us on this planet.

We need to get the information out on our effective practices, preventative measures, and common remedies. It is in all of our interests to help our fellow beings and at the same time online platforms like eZdia will help in ensuring that you are rewarded for your efforts.

In my next blog, I will focus on the health care systems in India, China and other developing countries.

• Advice , Doctors , Entrpreneurship , Health Care , Knowledge Platform , Nurses , Patients , experts , ezdia
• Comments(17)