STRUGGLE OF GETTING TREATED IN PAKISTAN
The Healthcare system of a country is much important as it has a direct impact on the economy of the country. Healthy manpower increases productivity by doing work in industries and as a result economy of that country increases leading to human welfare. Pakistan has inherited an inadequate healthcare system that was a heritage of the grand British period. The Healthcare System of Pakistan consists of two sectors. One is the public sector while the other is the private sector. The public sector serves 30% of the population while the private sector serves 70% of the population. Only 27% of the total population is benefited from full healthcare coverage and the remaining 73% depends upon out-of-pocket payments. It is because the public sector is facing different issues and private sectors provide a state of satisfaction to the patients. Even though patients face multiple challenges such as financial stroke but still they get treated from a private sector hospital just due to the unavailability of proper patient care in the public sector. The struggle of getting treated in Pakistan is a struggle of fighting disease and financial issues at the same time.
The private sectors in Pakistan play a vital role in the delivery of healthcare services. Most of the private clinics, hospitals, and health-related facilities are in urban areas. Private hospitals are well equipped with modern diagnostic facilities. These private healthcare options are in greater demand due to the facilities they provide than that of the public sector. The main issue with the private sector is that it charges a fee at the first visit and then recommends a follow-up after 7 to 15 days. In this follow up they again charge a fee. Private sector doctors are not devoted to treat patients and let them live life. They are just concerned with their business and have nothing to do with patients’ difficulties.
Due to private sector expenditures, poor people spend a greater proportion of their income on health care than do the rich, often using less qualified or untrained private providers. The private sector is a fee-for-service system. It means that these private provider services come at a cost, and the quality of service is uneven across providers. who tend to overprescribe medications and procedures. Moreover, most of the private doctors are geared towards medically profitable services such as Caesarian sections but often overlook essential preventive care such as newborn immunization, breastfeeding advice, and family planning support.
In our society, private sector doctors are visited usually to avoid long distances of public sectors from the patient’s residence. For women, it is more inconvenient to visit far away from the hospital due to some social and cultural reasons and they have to rely upon a male member of the household to accompany them to the clinic. Hence, patients usually decide to visit a nearby private clinic by paying the consultation fee rather than traveling far off from home where consulting a doctor is free as it time costs. In Pakistan, out-of-pocket healthcare expenditures are much high about 80-90%.
Government healthcare facilities are free but unfunded. Due to these chronically unfunded facilities and the absence of a funded healthcare system, private sector hospitals have flourished and have become a multi-billion dollar industry in Pakistan. Private hospitals, X-ray centers, laboratories, pharmaceutical companies, and medical device manufacturers are all cashing in.
In Pakistan, a cataract operation can cost anything from Rs. 50,000 to 150,000. In a private hospital, normal delivery ‘package’ is up to Rs 200,000-300,000 and an average cost of a private room is between Rs 8000-15,000/day without including charges for medicines, doctor’s visits, tests, or other services. The charges of an intensive care unit (ICU) bed can be as high as Rs 100,000/day or more. Consultation charges of a single visit with a specialist cost about Rs 2,000 to Rs 6,000. Due to some complications, if the hospital stay gets prolonged, the costs go up exponentially.
The innumerable private healthcare facilities have sprung up all over the country. They can charge whatever they want and there is no one to keep a check on them. Except for some private doctors, there are no mechanisms to address the grievances of patients. The medical negligence and poor quality of health care along with high costs of hospitalization is an act of violence.
Medicine is predatory in Pakistan as hospitals comply with each other to get a piece of the pie. Many hospitals are marketing their services to attract more patients while some hospitals offer a discount on the consultation on special occasions such as Ramzan or Eid. It has become common to see physicians and dentists ignoring the ethical and moral foundations of the medical profession. Every day, number of Pakistanis goes for X-rays, MRI test and CT which enriches labs and doctors but do little for the patients. Multiple labs are giving kickbacks to the referring physicians. Without a system to screen people in the community, people consult with specialists directly for minor problems.
In 72 years of freedom of Pakistan, neither the government nor any institution has developed comprehensive ‘health systems,’ for dealing with minor problems by family physicians at primary health care (PHC) units. The cases of moderate complexity should be treated by secondary care and only the more complex cases should be handled by specialists.
This all needs to be control by developing a health promotion approach using disease prevention by investing in a public-funded quality PHC system while focusing on the socio-economic and political determinants of ill health. There is an urgent need to regulate the private medicine sector of Pakistan which must include registration of hospitals, fee structures, quality standards, tax accountability, credentialing of healthcare staff, and systems for the complaints of patients. It also covers charitable and NGO health facilities, many of which operate under the principle of ‘something is better than nothing’ and must provide free healthcare which strips people of all dignity and respect.
American senator and presidential candidate Kamala Harris argued,
“I believe that health care should be a right, but the reality is that it is still a privilege in this country. We need that to change. When someone gets sick, there is already so much else to deal with: the physical pain for the patient, the emotional pain for the family. There is often a sense of desperation — of helplessness — as we grapple with the fear of the unknown. Medical procedures already have risks. Prescription drugs already have side effects. Financial anxiety should not be one of them.”