The Maharashtra health minister just announced that in order to improve healthcare for the citizens of the State , the government is going to provide medicines free of cost in government hospitals . Statements like this grab headlines, because they project that the government as taking concrete steps towards making medical care more affordable .
How can anyone argue with this proposal ? Isn’t it the government’s responsibility to provide healthcare for the poor ? And if they cannot afford it because doctors and hospitals are greedy and charge too much , doesn’t it make sense for the government to intervene and provide this free ? What could the possible harm be ?
Sadly, the law of unintended consequences ensures that these populist steps cause more harm than good. Measures such as this are announced before an election ( the Maharashtra Assembly State election is just around the corner) and are always helpful in getting a few more votes, but we know from bitter experience that subsidies never work well in real life. The ground reality is that when the poor patient goes to the hospital medical store to fill the prescription which has 5 medicines on it, 9 times out of 10, the store keeper will hand over a strip of aspirin tablets, and claim that the rest of the medicines are “out of stock”. It seems that they are always out of stock ! The reason is that most of them are sold in the black market , to enrich corrupt government and hospital officials .
Poor patients do not benefit from these schemes, but the reason government officials are very fond of launching these is because government officials do benefit from them ! These schemes are a great way of making money ! They are big-ticket items, which usually add up to hundreds of crores. The tender is usually awarded to a “ friendly company “, and the process allows scope for a lot of corruption. Even worse, this money comes from the taxes we pay, and is just being wasted. WE also need to think of the opportunity cost. These funds could have been better utilised for other more constructive purposes.
Patients rarely value anything which is given free – and most of them still believe that the medicines provided in government hospitals and sub-standard and of poor quality. They do not trust these, and prefer buying branded medicines using their own money.
Rather than try these cheap popularity stunts, it would be far more effective for an enlightened Health department to provide free Information Therapy for patients . This is such a huge opportunity for the government ! While patients are hungry for information, their problem is that they are not sure if online information is reliable or not. If the government provided this, not only would this be trusted, it would also allow the government to prove that it was spending its funds sensibly, in order to improve the health of its citizens !
Even better, this is an intervention which does not have any side effects . Bad doctors will no longer be able to take patients for a ride by exploiting their ignorance . Good doctors would be happy with this solution, because it’s much easier to talk to a well-informed patient, and it would save them time.