Aamir khan’s television show on the unethical practices by doctors indulge in, has expectedly rattled the medical community. Some doctors have even sought an apology from the actor for projecting profession in bad light. They may protest, but they can’t deny they grim reality.
Doctors are angry. Why? Aamir Khan has targeted them in two of his first four shows. And why not? After all, the show is called Satyamev Jayate. And the first and most important responsibility of a civilised society towards its citizens is that of giving them a good healthcare system (followed by education, employment and judiciary, in order to make a good democracy), that too in a country like India where an estimated 17 per cent of the population dies before the age of 40. The reality, however, is shockingly quite worse. The reality is that in this country, medicines for treatment of cancer patients — in one of the cases, 5,50,000 Morphine and 52,00,000 Morcontin tablets sent by the World Health Organisation — that were supposed to be distributed free at all the hospitals in India, were dumped beyond their expiry dates in the stores of hospitals . These were expensive medicines; Morphine is typically meant to relieve patients from intensive pain. It basically meant that in this particular case, patients who could not afford to buy such costly medicines from the market must have suffered immense pain, with some of them dying too without proper treatment. the WHO has, of course, demanded an explanation. But what is more important for the masses is that the medical mafia keeps engaging in such acts to enhance the profits of pharmaceutical establishments. I can easily cite scores of such examples from reports on the miserable conditions existing in hospitals all over India. Although examples of the opposite nature are becoming rarer by the day, there are sparkling exceptions, and it gives me immense pleasure to write about one such example — the Shramjibi Hospital in Belur, West Bengal. When the hospital admits a patient, it never asks the patient to deposit any money. Patients are almost always surprised to receive a very low bill (almost always one-fifth of the amount charged in other hospitals) when the treatment is over. For example, a coronary bypass surgery for the heart costs _25,000 at the hospital, inclusive of pre-and post-treatment charges. In the unfortunate case of the patient expiring during treatment, the management of this hospital never presents any bill to the relatives of the patient. Elsewhere, a bypass surgery may cost upwards of _1,00,000 to _3,50,000. Since patients can easily be blackmailed, life-saving drugs are priced exorbitantly. AIDS patients in US and Europe are charged up to $30,000 for one year of treatment. Cipla in India, for an equally effective medicine, charges only one dollar a day. It is so unbelievable and so noble a n act that even former US President Bill Clinton negotiated for an annual supply of drugs costing around only $100 per patient. This is exactly what Aamir Khan tried to point out. His contention was, “When a student sits for the MBBS exams and is asked what the medication for a patient suffering from diabetes is, he might write Glimepiride. This is the salt commonly used to treat diabetes. When this student becomes a doctor — and a patient who has diabetes comes to him for treatment — he might write the medicine’s name as Amaryl. So, is that young doctor prescribing the wrong medication? No. Amaryl happens to be one of the brand names by which the salt Glimepiride is sold. So what is the difference between the two, apart from the names? Well, a strip of 10 tablets of Amaryl costs around _125, while a strip of 10 tablets of the salt Glimepiride costs _2. Both are essentially the same. We pay approximately _123 more for the brand name.” However, doctors rarely prescribe a generic drug to a patient. In West Bengal for example, the earlier Health Minister, Surya Kanta Mishra, used to repeatedly request doctors to prescribe generic medicines, but to no avail. The drug industry spends on an average _2,00,000 per doctor per year in soliciting business and promoting branded medicines. It is no wonder that branded medicines are so expensive and doctors love them. They are often paid commissions on drugs sold directly or indirectly through quid pro quo reimbursements of various kinds — sponsorships to participate in international conferences, for instance. Investigations for diagnostic purposes are often superfluous and are priced high. One of the reasons is the commission (which can even be up to 40 per cent of the total amount) paid to the doctors who recommend such investigations. Even surgeons, whatever the degree of skill acquired by them, do not hesitate to extract prices that can be described only as brutal, ruthless, merciless and heartless. Also, since foreigners from developed countries are coming in droves for treatment in India, globalisation has led to an increase in the cost of treatment in Indian hospitals. The average cost of hospitalisation has increased by more than five times in a span of just 10 years. This can explain surely why hospitalisation costs are now beyond the reach of not only the common man, but also of the upper-middle class. We must take up the fight against reservation of treatment in modern hospitals for the creamy layers of Indians, whatever the caste. The only way to get rid of our very own ‘merchants of death’ is to devise a National Health System geared to Indians of all castes and classes, inclusive of people at starvation level and destitution level. More than a lifetime of an average Indian has passed after India achieved Independence. It is high time we did away with the famine of food as well as of medicine. It is high time we built in each blocklevel unit at least one hospital, modeled on the lines of the Shramjibi Hospital, humanised and efficient. No doubt, Aamir Khan’s show is garnering a TRP of only three or so and even the masses want him to be more combative than the ‘now school teacher, now teary’ mode of his, since unlike an Oprah Winfrey, Aamir is known to be an actor so his tears will often be looked upon by the public as mere melodrama. Also, his programme almost looks like a deglamourised version of The Oprah Winfrey Show, with poorer looking Indians vocalising their pains; Indians who give the TRPs now appreciate glamorous looking shows, especially if they have to get up early on Sunday morning. But Aamir’s case against the doctors is absolutely praiseworthy and specifically so in the light of our existing health system. (The author is a management guru and the honorary dean of IIPM Think Tank.)
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