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When I was a kid in India, going to a hospital wasn’t the nightmare it is now. Most hospitals were run by the government, and the place with the reputation for having the best doctors in town was our local medical college. The hospital was disorganized and messy but the treatment was usually effective. There was something homely about the place because we had friends and family working there. They could be relied on to give us a helping hand to get through the bureaucratic maze that was a government hospital of that era. But most important of all, the cost of treatment was reasonable, or rather affordable by an ordinary Indian.
The changing face of Indian hospitals
Then I grew up, left my hometown, went abroad to work. Though I would return regularly to see my mother, I didn’t enter a hospital in my hometown for many years until my mother needed a cataract operation done on her eye. Her friends who had the procedure done recommended one particular hospital. So that’s where I took her.
The place was a revelation as it was nothing like the old ragtag hospitals of India. With sparkling clean floors, glass doors, spick and span lifts, a reception with an array of computers manned by efficient staff in neat uniforms, well organized waiting rooms, and futuristic diagnostic machines, this looked like a premium hospital located in the US or Europe. I can’t say I was surprised when they asked us to pay in advance as the bill amount was sky-high. Luckily my mother’s insurance covered most of the expenses.
The Open Market Economy
What happened was the Indian government made a decision to turn the economy into an open market one. It was a good decision to break away from a socialist public-sector focused economy that had bogged down India in a slow-moving rut of inefficiency and corruption for over half a century. That unleashed Indian’s economic engine and has led to the progress of the last few years.
However, the Indian government made one mistake. They allowed healthcare and education to become part of this open market economy. These ‘services’ now became ‘service industries.’ This led to the establishment of hundreds of state-of-the-art hospitals all over India, which remind me more of 5-star hotels than the old rundown government hospitals of my childhood.
Free healthcare still exists but there’s a catch
India’s government hospitals still exist but cater now almost solely to the poor. Public healthcare in India is free and subsidized for those who are below the poverty line. The Indian public health sector encompasses 18% of total outpatient care and 44% of total inpatient care. Much of the public healthcare sector is in rural areas. The quality of service in these hospitals suffers because experienced healthcare providers are reluctant to visit rural areas. As a result, most of the public healthcare system in rural and remote areas relies on inexperienced interns who are only there because it’s part of their academic requirements to work in public hospitals. Add to this the long distances between public hospitals and residential areas, long wait times, and inconvenient hours of operation, and it’s easy to see why ordinary Indians avoid public healthcare.
What if you can’t afford it
Sometimes you get lucky. A cousin had chemotherapy treatment done for breast cancer at that same hospital where I used to go, and she’s fine now. Her expenses were partially subsidized by the government and that was the only reason she could afford it.
Others aren’t so lucky. An uncle of mine needs a liver transplant but refused to have the procedure done, even though his kids are willing to be partial donors (livers regenerate after transplantation, and the partial livers of donor and recipient will grow back into complete organs). His problem is the cost is prohibitive at around $50000 (₹37 lakhs). That is out of his reach as he’s lives on his pension, earned from many years working as a Forest Officer. He refuses to allow his daughter to pay for it even though she’s a doctor herself. I’m guessing he’s calculated that she would have to scrimp and save for 3–4 years to pay off that kind of money. That would come at some cost to her own family.
The thing is health is something no one wants to compromise on. My mother didn’t want to risk her eyes so she chose the private hospital that her friends recommended. But she made sure her insurance was valid there. Most Indians don’t have medical insurance as the concept is just catching on in India, and is mostly a perk offered by employers to make a job offer more attractive.
Too late for the industry to change course
Ideally, the Indian government should have realized that healthcare and education are essential services. They should be available and affordable by every Indian citizen. Yes, it costs money but the government could have generated funds by a tax that’s applicable to every citizen. I have friends who have migrated to Canada where they have implemented just such a system. My friends agree the taxes are high but people accept it. They know it comes back to them in the form of free healthcare and education for all citizens.
It’s a bit too late to change from open market to free service for India’s healthcare industry. These are businesses and they have already invested millions and need to recover it. There’s no going back.
The government did recently ask these hospitals to treat Covid patients for free. That’s impractical. The business expenses of the hospital have to be covered, which includes staff salaries, costs of medicine and equipment, utility bills, etc. Even then, if it’s a new hospital, it probably has huge loan payments to make. They aren’t going to be able to provide services without any money coming in.
I understand the business issues, but don’t have much sympathy for these hospital-businesses. Many of them show no signs of having a heart, and have absolutely no qualms in ruthlessly taking advantage of any situation.
To go or not to go
There’s this middle-aged couple in our locality tested positive for Covid, and got themselves admitted to a hospital. The treatment was minimal as they weren’t put on ventilators. They were just given some medicines and a daily check of oxygen levels. The hospital stay was for 5 days, and they were charged ₹30,000 per head per day, making it ₹3,00,000 ($4000) for 5 days for the two of them. The couple said that given a second chance, they would opt to not go to the hospital, and prefer to stay at home and treat themselves with traditional herbal remedies. In fact, I suspect a lot of Indians are doing just that even when suspect they have Covid, and that may include me. It helps that the death rate for Covid is very low in India.
The thing is the cost of treatment may not be much by Western standards, but it’s easily half a year’s income for an average middle-class Indian family.
Profiteering Vs Profiting
That is the essence of the problem of medicine becoming a business. Ethics often goes out of the window. It’s hard to stick to the line between profits and profiteering. A doctor friend who returned to India after working for years in the UK was asked by his employer to refer more of his patients for surgery. He quit in disgust and took up teaching. But for every principled doctor, there will be dozens of other doctors who have ‘invested’ millions to get into a medical college, and now need to recover their expenses.
This is what led to the situation where my wife’s grandfather had a heart attack and was admitted to a private hospital where he was put on a heart-lung machine. The thing was he was already dead when he arrived at the hospital but the hospital wanted to make some money. The family got lucky as my wife’s sister is a doctor. She quickly assessed the situation and had the life-support system disconnected. They still had to pay for one day of its use, which itself was a humungous price to keep a dead guy’s heart pumping. This kind of thing happens all over India and is giving the medical industry a bad name.
However if we change our perspective, there is a huge opportunity. These new hi-tech hospitals can deliver world-class medical services as they have invested in the latest facilities, medical equipment costing millions, and hired top class Indian doctors, including many with degrees from Western Universities.
The cost of treatment at these hospitals may be high by Indian standards but relatively cheap when compared to treatment in a hospital in say the US. Americans want top-quality treatment and top-quality service and these new hospitals can deliver easily on both fronts. Being staffed by doctors with degrees from Western universities is just the final touch of reassurance needed to clinch the deal. If these hospitals had seriously targeted Western countries, India could have become the world’s top medical tourism destination by now.
Take that $50000 for a liver transplant. My uncle found it too expensive, even though it was being done in one of the top hospitals in south India. The thing is it would cost $250,000 in the US. So doing it in India would work out economical for patients from abroad who are looking for quality care and good outcome at an affordable price.
Medical tourism is already happening in India, but in a small way. I know this successful Indian engineer who works abroad and is a diabetic. For all his brilliance, he was careless with his diet, and sugar, and taking his medicines, and ended up needing a liver transplant. He got it done in one of the better hospitals in south India, and went back to work abroad, and was doing fine till Covid struck. I’m guessing he must have quarantined himself as the transplant puts him in the high-risk category. Another friend, a US citizen, had eye surgery (retinal detachment) done here earlier this year.
Medical tourism needs to be promoted big time by the Indian government. It’s a huge opportunity as we have the skills but we need to grab it before China or some other country moves in and captures the market. This promotion by the government could be a win-win situation for local patients and hospitals as the latter could in return agree to subsidize treatment for Indian citizens.
So where does this leave the common Indian?
This combination of unaffordable prices and unnecessary treatment makes Indian hospitals a place Indians should stay away from. I have gone under the knife a couple of times unnecessarily, and also nearly had my kidneys destroyed by taking the painkiller paracetamol, that claimed to have ‘no side effects.’ So many years ago, I decided I would stay away from hospitals and medicines. My formula was prevention is better than cure, and exercise I felt was the best way to avoid falling sick.
Anyway, by a coincidence of luck, personal experience, being a fitness fiend, and having a wife who religiously avoids anything with chemicals, be it food or medicine, I ended up in figuring out how to live an alternate healthy life with a little help from India’s time-tested world of home remedies, and alternative medicinal systems.
An Alternate Healthy and Affordable LifeStyle
The Indian way of staying healthy is to take a holistic approach to health. Here’s my attempt to put together the various elements in this lifestyle.
Food is medicine
Let me illustrate what I mean by using my daughter as an illustration. She is a healthy teenager now. But as a kid, she had all the usual ailments that most kids are susceptible too. Every time she fell ill, we would take her to the pediatrician who would tell us what was wrong, and prescribe a whole lot of medicines, including antibiotics. What the doctor didn’t know was our sole intention of seeing him was to use his skills to diagnose what was wrong with our child. Once he confirmed it wasn’t anything dangerous, we would take her home, and give her my wife’s patented home remedies. For coughs, colds, and fevers, her favorite treatment is a ginger-lime-honey concoction. Plus hot saline gargles, lots of rest, backed up with lots of orange and pomegranate juices. The child usually recovers in a day or two. If she gets the runs, it’s a spoon of honey with a few freshly ground, black peppercorns.
A fit body can fight off disease
We also made sure our child exercised, and religiously exposed her to germs with a mandatory dip in the sea. This happened every weekend until we moved inland. After that, I put her into tennis and dance for a few years till she grew older, rebelled, and quit all activities. But the basics had been programmed into her. She’s now naturally fit and works out on her own. The kid is about to leave for University and to date has never taken a course of antibiotics, and rarely any medicines (I’m touching wood as I type this).
As for me, I do a combination of stretches and jogging/walking to stay fit. I had to take a break for the first couple of months of the Covid lockdown, but managed to stay fit with an exercise app. These days, I just go jogging on the local roads around my house as the entire area is pleasantly covered by large shady trees. It helps that the roads are deserted except for a handful of other diehard fitness freaks.
My wife believes only in natural foods so everything that comes in a packet is banned at home. Anything with additives, preservatives, food colors, or even white sugar is off the menu. The funny thing is after a while of eating healthy, you become more attuned to your body and how it reacts to the stuff you eat. For instance, if I eat white sugar now, I can feel a runny nose coming on. It’s almost as if my body is trying to get rid of the white poison that has entered my system. My daughter also complains I have messed up her life. She feels sick when she eats popular fast foods, while her friends have no issues.
I switched to a two meal a day lifestyle a couple of years ago. My body feels a lot better probably because autophagy is kicking in, and eating up all the dead cells within my body. Ugh! As a bonus, this diet has also freed up my mind from the tyranny of food. I don’t have to think about food after breakfast as I know my next meal is my evening dinner.
Alternative Indian Medical Systems
India has many alternative medical systems like Ayurveda, Siddha, and many more regional systems that I’m not aware of. Ayurveda is a holistic system that incorporates massage, physical yoga, and herbal-based medicines.
I haven’t delved too deep into this. But we have had immunity building herbal combos at home to keep Covid at bay. This includes a neem-turmeric mix, a gooseberry-turmeric-pepper-honey mix. Local grandmothers recommend a medicine called ‘nilavembu kashayam’ as an immunity booster. It’s made of a herb called ‘nilavembu’ (Andrographis) which has to be boiled in water to which you add a few herbs. I’m not too sure of the exact ingredients but I think they use things like honey, mint, coriander, turmeric, basil, ginger, pepper… Seems to be working as we have been Covid-free though it’s raging all over the city I live in.
I have been lately trying to get into yoga and meditation as that’s the ultimate fitness for mind and body. The stretching exercise I have been doing from my teenage days are mostly the physical side of yoga or the asanas. I also do a version of pranayama (yoga of breathing). I found that very effective and clearing out my lungs from what I suspect was a Covid attack.
However, the main part of yoga, which is meditation has always been difficult for me. I just can’t switch off my brain. My online guru says to forget about controlling the mind and focus on putting some distance between myself and my body and my mind. I’m still trying to wrap my head around that.
We still need hospitals
Despite my strong antipathy to hospitals, I haven’t been able to stay away from them. That’s because traditional medicines have limitations. They are slow-acting and usually best used as preventives. They can’t be used for serious illnesses or emergencies. So it’s best to use it in combination with modern medicine. Here are the four to five occasions I have had to visit the hospital in the last ten years.
Diagnosis: Doctors have spent years acquiring the skills to recognize dangerous diseases. So they are my favorite diagnostic tool. For some reason, I was always worried my baby daughter would catch ‘whooping cough.’ Its name conjured up alarming visions of my kid whooping like a cowboy chasing a cow with a lasso. That way, doctors are an effective early warning system. Once you know the exact issue, you can figure out how best to handle it.
Tummy upset About six years ago, I had a series of recurring episodes of diarrhea. Since my father had colon cancer, my doctor brother recommended I get it checked out as a precaution. Having a camera up my backside was mortifying, and only reinforced my desire to stay away from hospitals. Oh, there wasn’t any cancer and in hindsight, I think it was amoebiasis.
Accidents Around five years ago, I stubbed my toe badly on a submerged rock in a lake I was paddling around in. I had an X-ray taken, and the doctor confirmed a hairline fracture. It was the middle toe, so they couldn’t put a cast. But he immobilized it by tightly binding it with my second toe, and banned all exercise for ten days. Fortunately, there were no complications.
Root canal I had a couple of wolf teeth which I was too scared to extract. Big mistake. My toothbrush wasn’t able to get at food particles stuck between the wolf tooth and the molar, and a cavity developed in the molar. The dentist said the wisdom teeth had to go and a root canal had to be done on the molar. I had to make about 3–4 visits to the dentist to get the job done. I still feel the dentist could have let my wisdom teeth be, as that was my last shot of becoming a wise guy.
Ingrowing toenail This one happened a year ago and was very painful. I couldn’t extract it with my crude tools, and it was getting infected so I was left with no option but to drag my feet to the hospital. The good surgeon wanted to entirely remove the nail for a permanent cure. I requested to him just cut off a thin slice on that side of the toe. He was doubtful about the whole thing as he couldn’t see the offending bit. But he finally agreed to do it, and was a bit surprised to see I was right about a thorn-like growth. The toenail has grown back now and I’m thankful I didn’t give in to the surgeon’s natural instinct to cut first and ask later.
Thankfully, except for my mother’s cataract surgery, none of the above were financially killing. Maybe I got lucky. I’d like to think I made my own luck.
Good luck, people. Eat healthy, exercise, diet, meditate, opt for home remedies, and do whatever you can to stay away from those hospitals. Yes, I did say meditate, because it’s worth trying anything and everything, rather than risking ending up in the clutches of those bloodsucking businesses.
My post was inspired by this video. He has an amazing ability to simplify things.