Indian healthcare is at a critical crossroad. There has been significant improvement in the control of morbidity due to communicable diseases. On the other hand, non-communicable diseases have become a major cause of morbidity and mortality. Simple community-based interventions like sanitation, clean water supply, vector eradication and vaccination under nationwide program initiatives helped control communicable diseases. Similar strategies do not exist for non-communicable diseases, where the prevailing paradigm is the reactive use of expensive curative services. To some extent, the burden on patients who paid for such services out of pocket has been reduced by increase in capacity and supply of curative services under schemes like Ayushman Bharat. However, in a system where providers control the levers of consumption, for profit providers are incentivized to artificially stoke consumption until demand once again catches up with supply, setting up a vicious spiral of inflation in healthcare costs. Scaling up such a supply led healthcare system, in order to make healthcare universally accessible, is a recipe for unsustainable increases in healthcare costs.
The book Mission Possible takes a hard look at the realities of Indian healthcare and provides a way out of the unsustainable trajectory it finds itself in. Instead of considering the pieces of healthcare in isolation, it promotes a systemwide analysis of the problems. Based on our analysis, we have not hesitated to propose radical structural changes in the current system, while providing commentary on why these changes are necessary and how they could be realized. The details of these proposals can change, but there are six guiding principles that can be distilled from our commentary.
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