Health is wealth only after wealth creates health.

At 60% of total health expenditure India has the highest out-of-pocket expense on healthcare, in the world, writes Kenneth Thorpe from Emory University in the US. 47% of hospital admissions in rural areas and 31% in urban areas are financed by taking loans or selling assets, trapping people in poverty. Health insurance is useless because it covers only hospital admissions but not chronic care, does not cover old people and the cover provided is totally inadequate. Only the rich can afford the premiums for insurance cover of over Rs 2 million. It has been shown that wealth determines the health of people (Angus Deaton, Nobel Prize winner). Wealthy people have better living condition, are better educated, so have more knowledge about a healthy lifestyle, have better nutrition and are better able to protect their children by immunising them against childhood illnesses. All that seem obvious, what seems counter-intuitive is that as a nation gets wealthier its health cost tends to rise exponentially. The reason is that people live longer, which means a larger proportion of old people, and communicable diseases are replaced by non-communicable diseases which are far more expensive to treat. The cost of vaccinating every person against small pox and polio, both of which have been eradicated from India, is an infinitely small fraction of the cost of treating diabetes, high blood pressure, chronic kidney disease and cancer. Private hospitals are dens of corruption, which most people cannot afford, government hospitals are overloaded. To treat people you need doctors. Medical education is very poor in India and even that is becoming very expensive. The gap is filled by unqualified quacks. Only 43% of allopathic doctors, practicing western medicine, have a MBBS degree, the rest are cowboys. What are politicians going to do about it? As is usual in India their first reaction is to use force. Doctors are being denied permission to work abroad so that they are forced to return home. The hope probably is that starvation will force doctors to work in villages and politicians will claim a great victory. Old people are most in need of medical care but cannot get insurance. India comes last in its care for old people, with more than half living in poverty. Government fellows, on the other hand, have seen a 157% increase in their pensions recently. Uncontrolled inflation, low interest from bank deposits and lack of any returns on years of paying taxes makes retirement a curse for most. To provide healthcare to all India has to become a wealthy nation and for that we must reduce the number of people. Nothing else will work.