I am a Doctor by profession and presently working in a Government Hospital in India. Since it is a Govt hospital and treatment is provided free of cost, the usual patients mostly belong to the poor class who cannot really afford to pay medical bills. Most are daily wage workers and barely earn enough to get by with their day to day lives..therefore proper premium treatment for their illnesses is a luxury they cannot afford. Therefore, pressed on by their financial burdens, they come to Govt Hospitals where they hope they can get the treatment they need and gain their health back.
Medicine is such that the full spectrum of a persons treatment is never really carried out in one place all the time. Sometimes there can be referrals eg.to other super speciality hospitals or the patient has to be sent out for diagnostic tests to other centres. Sometimes he might have to run for speciality blood tests not done where he is admitted or just run around to get blood of a particular group to get the transfusion he needs. Now, all this costs money. The hospital where is is admitted might well be free of cost..but referrals, tests, etc outside the hospital are not. The patient ‘will’ have to spend money. An example of this I came across was when a patient suffering from haemolytic anemia was admitted to our hospital. We did all we could to provide him with the best treatment free of cost, but ultimately a bone marrow biopsy was needed for which he was referred out to a diagnostic centre. The biopsy would cost him over a thousand rupees. On being told about this, he asked whether it was possible to perform the test in the hospital as he was low on finances. On being told no, there was a clear take-over of despair on his face..wondering as to from where would he arrange a thousand rupees for a test so necessary to his well-being.
The Hospital in these cases is thought to be at fault but it is not the case. These hospitals, the treatment in them being free, have a tremendous amount of patient influx. The medicine wards, surgery and gynaecology wards are sights to see. Patients even lie down on the floor when beds are not available. In these circumstances, maintaining a continuous supply of medical drugs and equipments are not possible. The sheer flow of patients completely overwhelms the supply of medical items in the hospitals. It is a common sight to see supplies running out as newer patients keep getting admitted. In these circumstances, the patient has to spend money in buying supplies that would have otherwise been available free of cost.
Therefore, we see that even free healthcare is not truly free when we look at the big picture. So who is to blame here? The people? The hospital? None. It is poverty. Until poverty is not done away with, until the financial state of people does not improve – even healthcare – being such an essential element of life that should be provided to anyone and everyone free of cost – will only remain a dream come true for people who can afford it.