Healthcare will witness a revamp post-COVID-19. The transition has already commenced, it is just a matter of time before the health industry spearheads the new normal. Talking about the new normal and the opportunities ahead in healthcare was Dr K Hari Prasad, President of Apollo Group Hospitals at a webinar ‘India After COVID-19’ organised by The Free Press Journal and IIM Indore, supported by Big FM and Moneylife.
The latest edition of the webinar series, which was on the healthcare sector, was moderated by FPJ's RN Bhaskar and by Himanshu Rai, director, IIM Indore. Below are edited excerpts of the session compiled with editorial support from Jescilia K.
Watch the complete video here:
Impact of epidemics on people and lives
Epidemics have been here for centuries — Cholera, Plague, Spanish Flu, HIV AIDs, Swine flu, Ebola and others. Each of the epidemics has left behind a huge impact on the world on multiple fronts —geopolitical, geo-social, socio-economic. In the 19th century, when Napoleon Bonaparte was marching and going to conquer the world, he had to stop because there were two epidemics that had broken out — in the east was Yellow fever and in the west was Typhus fever. So, he could not continue with his plan and the world was saved because of that.
In the 20th century, HIV AIDs brought about a change in sexual behaviour. In the current century, it is COVID-19, this will lead to a new normal.
It will have an impact on almost every aspect of our living — eating, travelling, gathering etc. There will be a change in a big way.
Over the years, none of the viruses that has caused an epidemic has been eradicated except for smallpox and polio. So, COVID-19 is not going to go. If you are sitting at home expecting COVID-19 to disappear and then decide to come out, it could mean that you will be sitting at home for the rest of your life. COVID-19 is there to stay.
Unless, of course, there is a vaccine. Thus, the only other way to stay safe from the virus is by adopting precautionary measures. This pandemic will have a lasting socio-economic impact on the world.
COVID-19 will introduce changes
The first and the foremost change will be the behavioural change on the individual and the people living in communities. There are some things that have been taught to us since childhood but we never paid heed to them. Now, COVID-19 will make sure we pay attention to them and follow them. Hygiene, wearing a mask, and social distancing will be the biggest behavioural changes people will have to practise. And if you are not able to deal with this then get ready to welcome the virus back into your life.
Other trends will be less travel; more use of digital platforms; and more digital transactions. It is going to have a huge economic impact on the world. This impact is not because of the virus but due to the way we are responding to it. In India, the lockdown is a great example of the response to the virus. This impacted the economic activity of the country. It will take a few years for the economy to improve.
Private sector: Critical for healthcare
About 80-90 per cent of healthcare services in India is provided by the private sector. And the private sector is not a large organisation like Apollo Hospitals. It is usually the individual doctor and the small nursing homes that serve the population.
Large hospitals like us provide less than 5 per cent of the total healthcare needs.
Today, the healthcare services, which are usually provided by individual doctors and small nursing homes, are shut down and they are the most hit during this time. The foundation of the whole healthcare system in our country has collapsed due to COVID-19. We do not understand that it is this set of people who are providing actual health care. This COVID-19 obsession has shaken up the foundation of healthcare. This has changed the social fabric of society.
Today, the doctors are scared that they will contract the virus. Today, there are many asymptomatic carriers of the virus. So, they end up moving around and innocently infecting others in the community. So, the single-clinic doctors and smaller hospitals are scared and they are not ready to start operations. The larger players like us today run on 20-30 per cent occupancy after the outbreak of the pandemic.
Drop in the number of patients coming to treat other ailments
I cannot fathom this dip as other illnesses like heart attack, stroke, cancer etc have not gone anywhere. They are there in the community. But, people are not coming forward to get them treated. This is because the general public thinks all the viruses are in the hospital. I would counter that because the doctors and other medical practitioners are more cautious compared to the common man outside. It is probably safer to go to a hospital rather than going to a restaurant or any other public place. The doctors have the responsibility to take care of the rest of the medical staff and the patients as well.
Due to COVID-19, people are postponing their treatment that has impacted the overall health of the people. It has to be noted that since the COVID-19 outbreak, more people have died or even suffered, due to other illnesses rather than COVID-19. At the peak of COVID-19 in China, it was found that COVID-19 was the 40th biggest cause of death in the country. Even at the epicentre of the epidemic, the numbers were not high compared to other illnesses. Do not get scared of the pandemic, but learn to take precautionary measures. Do not postpone health, it will serve no good.
As an industry, we are trying to bring back confidence in the single-doctor clinic and small nursing homes. We have to showcase to the general public the way these medical professionals take care of themselves and of their patients. While we help these private practitioners to get back on their feet, we look to the government to support larger hospitals like us with industry-friendly policies.
Make health insurance must
Health insurance should be made mandatory. So that everyone can have financial access to healthcare easily. In the case of geographic access, once there is provision for financial access and there is sustainability, the geographic side will improve too. There will be more hospitals in tier II and III cities. There will be a good scope for growth. We are also waiting for the right opportunities (to expand).
Ayushman Bharat: Is the price of packages feasible?
At the current rate, the scheme is not sustainable. In any other category, you can create a different segment of services, but if you are doing a bypass surgery then you have to do it the same way, for the rich and for the poor, with the same caution and outcome. We do not want to land in a situation where we are pushed to use inferior quality material which we will never do. The government was evaluating the possibility of increasing the cost for various treatments but, due to COVID-19, that decision was put on hold. The government is aware that with the current tariff, there will be a sustainability issue.
Future: It’s very clear
Expensive or cost-efficient: Healthcare will become more expensive because every healthcare professionals will follow precautionary measures like using PPE kits and disinfectants etc. So, these measures would not be limited to healthcare workers but will be extended to the patients as well. However, the general expectation would be to provide more for less (cost).
We are used to this expectation. But in the present scenario, it will be very different. At the same time, healthcare institutions will work towards becoming more cost-efficient. These institutions have already commenced on the process.
Technology: It will play a bigger role in healthcare in terms of processes and systems; and access to healthcare and diagnosis among other areas.
After the outbreak of COVID-19, people have started opting for tele consultancy due to the fear of the spread of COVID-19. For almost 20 years, telemedicine existed but the number of telemedicine consults that happened in the last 60 days, never happened in the last 20 years. Tele diagnostics are going up in a big way. Then, there are wearable devices that will help in treating illnesses better.
Due to the use of technology, home care will become huge.
Digitisation of patients' information will also be equally important. Apollo Hospitals has given importance to the healthcare data of patients. At the same time, we have given the utmost significance to safeguard privacy.
Robotics will play an important role in the sector. Robotics surgery already exists and now there are robots that have been assigned the responsibility of disinfecting the hospitals.
Technology will be critical in the case of genetic-based treatment for an illness like cancer and others.
There will be new models of treatment that will come. Right now, the health sector is in a transition phase, which is always difficult.
Preventive: This will play an important role too. For this to evolve, the public-private-people partnership will have to exist. Unless all stakeholders come together to design and create a model, we will not be able to sustain. A unified approach will be a win-win situation for all.