Assignment

Interim Report

In partial fulfillment of Course:

Business, Governance & Policy

Submitted by:

Section B - Group 10

Aiswarya Biradavolu – P19065

Akshit Choudhary – P19067

Abhishek Jagdale – P19074

Gaurav Kishore – P19078

Fareed Ahmad Sheik – P19098

Devanshu Verma – P19114

Date of Submission: 2nd February 2020

Contents
1 Introduction........................................................................................................................................3
1.1 Healthcare System in India..............................................................................................................3
1.1.1 Public Healthcare Sector...........................................................................................................3
1.1.2 Private Sector............................................................................................................................4
1.1.3 Financing..................................................................................................................................5
1.1.4 Governments Initiatives............................................................................................................5
1.2 Healthcare System in Singapore......................................................................................................5
1.2.1 Private Healthcare.....................................................................................................................5
1.2.2 Public Healthcare......................................................................................................................5
1.2.3 Financing..................................................................................................................................6
1.3 Health Status....................................................................................................................................6
1.3.1 India..........................................................................................................................................6
1.3.2 Singapore..................................................................................................................................7
1.4 References.......................................................................................................................................7
1 Introduction
The healthcare sector is part of the economy, which is a combination of companies specialized in
products as well as services related to medical and health care.

1.1 Healthcare System in India

India has an extensive health care system, but there are also many differences in quality between
urban and rural areas, as well as public and private sectors. The state government majorly controls the
healthcare sector, state governments provide health education and services, while the central
government offers technical assistance and administration. The public healthcare system in India has a
feeble reach to society, which automatically takes them to private healthcare providers. Even though
the healthcare industry is one of the largest service sectors in India, it faces vast disparity in terms of
facilities available for urban vs. rural. The healthcare system in India is divided into five parts Public
Health Sector, Private Sector, Indigenous system of medicine, voluntary health agencies, and national
health programs.

Healthcare System in India

1.1.1 Public Healthcare Sector

Facilities available in Public Health care system is divided into primary, secondary and tertiary levels.
Primary services consist of Subcentres and Primary health centres located near rural areas to provide
necessary health facilities at remote and backward areas. More complex cases are then referred to
community health centres and District hospitals which provide secondary health services in India.
These centres have 24 hours available doctors and blood bank and family business planning and
services. Tertiary health care services like cancer, HIV etc. which require specialist treatment and
modern Technology are taken up by AIIMS and other Specialist hospitals.
 Public Healthcare Sector

1.1.2 Private Sector

The private sector is one of the leading providers of healthcare in India, especially in the urban areas
where the propensity to spend on health services is high. The change is being led by major players
who run big hospital chains like Apollo and Fortis, whereas twenty years back, the private players
were practitioners and small/medium hospitals and nursing centres. These Hospitals are run for profit
organization hence are closer to urban centres. Through PPP (Public-Private Partnership) Government
has been able to provide quality service of the private sector to lower strata of the society.

Indigenous System of Medicine

The indigenous system of medicine provides the Indian health seeker with an alternate route of
medication than the conventional western or allopathic medicine. These are divided as follows

Indigenous System of Medicine

1.1.3 Financing

The healthcare sector is primarily financed through government initiatives and schemes like
“Ayushman Bharat Yojana” which provides free access to healthcare services for forty per cent of the
sparse population by producing the primary, secondary and tertiary services. The rest of the
population depends on out of pocket payments and private insurance to fund for their healthcare
services. Social health insurance schemes like CGHS and ESIS are available for employed
individuals, but the majority of Indians work in the unorganized sector, which can not avail these
insurance services.

India has an extensive health care system, but there are also many differences in quality between
urban and rural areas, as well as public and private sectors. The state government majorly controls the
healthcare sector, state governments provide health education and services, while the central
government offers technical assistance and administration. The public healthcare system in India has a
feeble reach to society, which automatically takes them to private healthcare providers. Below are
some Indian healthcare scenarios

1.1.4 Governments Initiatives

 Establishment of new All India Institute of Medical Sciences across the country.
 Launched Pradhan Mantri Jan Arogya Yojana to provide health insurance to more than 100
million families every year.
 The government of India has approved Ayushman-Bharat national Health protection system
for northeastern states and UT.
 The GOI has launched the Indradhanush Mission to increase the coverage of immunization.

1.2 Healthcare System in Singapore

Singapore is one of the few countries to implement Universal Healthcare Systems (where citizens can
access health services without incurring any major financial constraints) thereby ranking 6 th on the
most efficient healthcare systems in the world by WHO.

1.2.1 Private Healthcare

There are major hospitals in Singapore like Parkway Pantai and Raffles medical group where 80% of
the beds are assigned for the Public healthcare. There is a unique system in Singapore where Beds
have been categorized into Five classes ranging from A class to C class with a varying spectrum of
services. The A-class, where patients are allotted single air-conditioned rooms, follows the measure of
payment of the medical bill by the patient; whereas the C-class has the provision for common
dormitory and is completely borne by the government.

1.2.2 Public Healthcare

There are about 1700 General practitioner (GP) clinics in Singapore that serve about 80% of the
healthcare needs and are owned by medium and large corporate houses. Approximately 80% of the
Singaporeans receive their healthcare from the Public Health System and the government spends
about 1.6% of the GDP on the Public health system. Public hospitals in Singapore enjoy complete
autonomy and compete with each other on the patient fronts.
1.2.3 Financing

The basic framework for Singapore Healthcare financing has the 3M’s framework namely; MediSave,
MediShield, MediFund.

 MediSave is a kind of social security payroll levy which has been mandated by the
government for the working Singaporeans for a health savings account. This ranges from 7%
to 9.5% of the salary of the working Singaporeans and is more like the twin sharing system
and is similar to provident fund contribution.
 MediShield is the insurance policy run by the government and is automated for everyone to
take it up. In this, the premium is set according to your age which accounts for about $1400 in
US Dollars.
 MediFund is an endowment fund for those who slip through the threads of MediSave and
MediShield and acts as a safety net for the citizen of Singapore. Medifund is based on $3
Billion funds and is financed by previous year investment income.

1.3 Health Status

To understand the Health Status of India and Singapore, three indicators, namely Under-five
mortality, Neonatal mortality, and Maternal Mortality Rate, are considered, which are also sustainable
development goals(SDG) set by the United Nations.

1.3.1 India

India, since its independence, has shown a significant improvement in all three indicators with MMR
declining from 2000 per 100,000 live births in 1947 to 130 in 2016. The neonatal mortality rate has
dropped from 146 per 1000 live births in 1947 to 25 per 1000 live birth in 2016, whereas the Under-
five mortality rate has declined from 280 per 1000 live births to 36 per 100 live births in 2018. Even
though India has achieved considerable reduction is these indicators, it still lags behind the developed
nation as well as some of its neighboring countries such as Sri Lanka, China, and Thailand.

To meet the SDG targets and to further improve these indicators Government launched the National
Health Protection Scheme “Ayushman Bharat.” This scheme has almost 50 crore beneficiaries under
its ambit and provides coverage up to ₹ 5 lakhs/family each year for secondary and tertiary care.
Also, the government has proposed to set up 1.5 lakh Ayushman Bharat health and wellness centers to
promote preventive healthcare. Society can benefit from Ayushman Bharat scheme as along with
public hospitals coverage this scheme also provides coverage in private hospitals. Private hospitals, in
turn, provides the required medical facilities and bridges the gap caused by lack of resources of the
government. Private investment in healthcare has lead specialized hospitals to come into existence.
Many hospitals focus only on infant and maternal care and hence these Hospitals have a role in the
improvement of indicators such as IMR and MMR.

Another way in which businesses are impacting Healthcare in India is by CSR. The government of
India has made it mandatory for companies to contribute 2% of their net profits, which have net
income more than ₹ 5 crores. About 24% of CSR spending is focused on healthcare. Healthcare
giants such as Apollo and Fortis hospitals have their dedicated CSR foundation and aims at improving
Healthcare in India.
1.3.2 Singapore

Singapore has one of the best healthcare in the world and it is evident with all the three indicators
which we have selected being below the SDG goals. This was not always the case; since its
independence in 1963, the government focused on improving sanitation and outbreak of diseases by
moving population from slums into flats constructed by the Housing Development Board. Along with
the focus on the healthcare government also focused on the education of its people.

Singapore’s 3M framework i.e., Medisave, Medishield, and Medifund has enabled healthy
competition between private and public hospitals, which tend to bring down the healthcare rates as
public hospitals are subsidized. In 2013, the Singapore government launched the Medishield Life
Plan, which provides mandatory coverage for life to all.

Though Singapore does well in most of the health indicators, the country has a problem with the aging
population. The government needs to take care of the changing needs and implement policies
appropriate for the aging population

1.4 References

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