A PROJECT ON

“GLOBAL HEALTHCARE SYSTEMS

WITH RESPECT TO SPAIN”

BACHELOR OF COMMERCE
ACCOUNTING & FINANCE
SEMESTER-VI
ACADEMIC YEAR 2021-22

SUBMITTED
IN PARTIAL FULFILLMENT OF THE
REQUIREMENTS FOR THE AWARD OF DEGREE
OF BACHELOR OF COMMERCE- ACCOUNTING & FINANCE

BY
ABHINAV NARAYANAN
UNDER THE GUIDANCE OF
PROF. PRATEEK KUMAR
ROLL NO: 46

JAI HIND COLLEGE, AUTONOMOUS

‘A’ ROAD, CHURCHGATE, MUMBAI 400020.

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 EVALUATION CERTIFICATE

This is to certify that the undersigned have assessed and evaluated the project on,
“GLOBAL HEALTHCARE SYSTEMS WITH RESPECT TO SPAIN”

Submitted by ABHINAV NARAYANAN student of TYBAF

This project is original to the best of our knowledge and has been accepted for Assessment.

________________ ______________________
Course Coordinator Principal

________________ ____________________
Internal Examiner External Examiner

______________________
College seal

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 DECLARATION

I, ABHINAV NARAYANAN, Student of BCOM ACCOUNTING& FINANCE hereby

declare that the project for the titled GLOBAL HEALTHCARE SYSTEMS WITH
RESPECT TO SPAIN
Submitted by me for Semester-VI during the academic year 2021-202, is based on actual
work carried out by me under the supervision of Prof. PRATEEK KUMAR.

I further state that this work is original and not submitted anywhere else for any examination.

______________________
Signature of student

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 ACKNOWLEDGEMENT

The successful completion of project involved the contribution of time and efforts.

The project would never have been completed without the valuable help extended to me by
my project guide Prof. PRATEEK KUMAR

I would also like to thank all my friends and family to help me in this project work and giving
their precious time to me.

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EXECUTIVE SUMMARY

A health system consists of all organizations, people, and actions whose primary intent is to
promote, restore, or maintain health. This includes efforts to influence determinants of health
as well as more direct health-improving activities. The World Health Organization (2000)
redefined the main purpose in its definition of a health system as “all activities whose
primary purpose is to promote, restore, and maintain health.” In recent years, the definition of
“purpose” has been further extended to include the prevention of household poverty due to
illness. Health systems are known as open systems because they are open to influence from
external factors such as poverty, education, infrastructure, and the broader social and political
environment. A health system’s many parts operate at many levels to provide coherence at
community or national level.
There is a wide variety of health systems around the world, with as many histories and
organizational structures as there are nations. Implicitly, nations must design and develop
health systems in accordance with their needs and resources, although common elements in
virtually all health systems are primary health care and public health measures. In some
countries, health system planning is distributed among market participants. In others, there is
a concerted effort among governments, trade unions, charities, religious organizations, or
other coordinated bodies to deliver planned health care services targeted to the populations
they serve. Health care often includes inequities in accessibility or quality of health services.
Coverage of health care is often not provided or of a good quality with universal health
coverage still not available in many countries worldwide.
The analysis has been carried out with the help of a questionnaire, based on basic questions
about healthcare being asked to the general public and a bit of knowledge awareness
questions to experts. The questionnaire has been subjected to the experts both in private as
well as public hospitals. Relevant information has also been collected through interviews
with the experts. The analysis is purely descriptive in nature. Percentages have been
calculated wherever required. A survey was conducted amongst 210 general public and 15
healthcare experts for this research.

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 Table of Contents

Sr. No. Title Page No.

1 Statement of Problem 7
2 Scope of Study 7
3 Importance of Study 8
4 Limitations of Study 8
5 Conceptual Framework 9
6 Review of Literature 10
7 Secondary Data Analysis (Spain) 13
8 Secondary Data Analysis (India) 26
9 Primary Data Analysis (General Public) 31
10 Primary Data Analysis (Experts) 41
11 Conclusion 70
12 Recommendation 71
13 Bibliography 73

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  Statement of the Problem:
There is limited preventive health care and services to promote optimal health and wellness,
and avert worsening of sequelae for children and adults with disabilities. Across the
healthcare continuum, integrated approaches are needed to simultaneously address the many
risk factors and conditions, as well as the medical, functional and societal limitations
including determinants that influences the health and wellbeing of persons with disabilities.
To effectively and equitably address the disparities in the continuum of care, cross-cutting
and integrated strategies can include epidemiology and surveillance for early detection and
prevention or to inform needed programs, environmental and community approaches to
promote health, support healthy behaviors, including wellness centers to promote healthy
lifestyles and intervention that reduces barriers to care and improve the effective use of
clinical and preventive services for persons with disabilities. This also means increasing full
participation in the community, by reasonable modifications of policies, practices, and
procedures.

 Objectives of the Study:

1. To understand what the general public and experts think of the Indian healthcare system.
2. To find out the major challenges faced by India’s healthcare system.
3. To get an understanding of Spain’s current healthcare system.
4. To compare the healthcare of Spain to healthcare of other countries.
5. To look at the challenges faced by Spain’s healthcare.
6. To analyse the country’s past performance of healthcare.

 Scope of the Study:

Geographical Scope:
The scope of the present study is confined to people living only in India only.
Subject Scope:
This study will focus on the working of the healthcare system of India and Spain, how it has
performed in the past, the challenges faced by it, what it plans to do in the future and how
does it fair when compared to other healthcare systems.
Sample Size:
Google forms have been used as a questionnaire to collect primary data. The sample size is
15 healthcare experts and 210 general public.

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  Significance of the Study:
This study will focus on the healthcare systems of Spain and India. It will aim to get a brief
understanding of how their healthcare system works. Specially during the covid-19
pandemic, there has been a trend to study how various countries have handled the situation. It
mainly shows how effective the healthcare system was. This study will also review how the
country has handled the covid situation, what were the challenges faced by it, and how
effectively it was in handling them. This study will also state how the healthcare system has
evolved over the years, what changes have been made over the years and what are the things
that it plans for the future. This study will also analyse the performance of the healthcare
system, by going through the past data of various indicators like mortality rates, readmissions
in hospitals, patient experience, timeliness, and effectiveness of services etc. The study will
also try to compare their healthcare with other countries, understand and analyse what it
needs improvements on and what it is already good at.

 Limitations of the Study:

1. The survey data collected will only comprise of 210 general public and 15 healthcare
experts, thus the data extracted might not be representative.
2. The primary data has only been collected from people of India.
3. The data used in the study of Spain’s healthcare will be secondary data, since no primary
data has been collected.
4. The secondary data used might not have been updated to the current situation.
5. The study will only focus on the healthcare system of 2 countries, Spain and India.

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 Conceptual Framework

Healthcare System of Spain:

1. Overview of the Spanish healthcare system
2. Management (How hospitals in Spain are being managed)
3. Primary Healthcare Services (Structure of Public Healthcare of Spain)
4. Private Healthcare (Structure of Private Healthcare of Spain)
5. Funding the System (How the system is funded, how much funds are allocated)
6. Healthcare Resources (Current number of resources available and future growth)
7. Healthcare Challenges (Current challenges faced by Spain’s Healthcare system)
8. Factors influencing inefficiency in Spanish health system (Reasons for the
inefficiency of Spain’s Healthcare)
9. Conclusion (Summarizing all of Spain’s healthcare system)

Healthcare System of India:

1. Understanding How India’s Healthcare System Works (Basic understanding of
India’s Healthcare system)
2. Overview of the Indian Healthcare System (Brief overview of how the system works)
3. Who is Eligible for Healthcare Coverage? (Talks about the eligibility of who can avail
health services)
4. Healthcare Options for Expats and Foreigners in India (What can foreigners and
Expats expect when travelling to India)
5. Costs of the Healthcare System (How much it would cost for healthcare in India)
6. The Differences Between Private and Public Care (Summarizing the major
differences between private and public healthcare)
7. Rural Healthcare in India (Brief introduction to rural healthcare)
8. Conclusion (Summarizing all of India’s healthcare system)

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 Literature Review

A cost and performance comparison of Public Private Partnership and public hospitals
in Spain
Maria Caballer-Tarazona & David Vivas-Consuelo

Public-private partnership (PPP) initiatives are extending around the world, especially in
Europe, as an innovation to traditional public health systems, with the intention of making
them more efficient.
There is a varied range of PPP models with different degrees of responsibility from simple
public sector contracts with the private, up to the complete privatisation of the service. As
such, we may say the involvement of the private sector embraces the development, financing
and provision of public infrastructures and delivery services.
In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other
European and Latin American countries is evaluated for first time: the integrated healthcare
delivery Alzira model.
Through a comparison of public and PPP hospital performance, cost and quality indicators,
the efficiency of the PPP experience in five hospitals is evaluated to identify the influence of
private management in the results.
Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good
results, above the average, but not always better than those directly managed. It is necessary
to conduct studies with a greater number of PPP hospitals to obtain conclusive results.
In summary, regarding the performance and efficiency analysis, it is seen that the PPP group
obtains good results, above the average for those directly managed, but not better in every
case. Therefore, the results are not conclusive enough to clearly opt for one model of
management; in both cases strengths and weaknesses were identified.
Nevertheless, our robust data base allowed us to begin taking the measure of Public-Private
Partnership Hospitals in VC.

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Public resource usage in health systems: a data envelopment analysis of the efficiency of
health systems of autonomous communities in Spain
[Link], Fernández-Montesb, Gavilance, Velascoce
Objectives
The efficiency in the management of public resources is one of the main pillars of the welfare
state. The objective of this work is to analyze the efficiency of the public resources that
regional governments in Spain (Autonomous Communities (AC)) invest in health systems
(HS).
Study design
A dataset from of the Ministry of Health, Social Services and Equality of Spain has been
used, which contains the most important indicators from the National HS. The following
variables have been chosen in this study: the health care expenses per resident, the percentage
of this investment that is forwarded to labour expenses, frequency of hospital care services,
frequency of specialized external health care services and, primary health care services in
medicine and nursing per resident.
Methods
To this end, Data Envelopment Analysis (DEA) is applied, which enables researchers and
managers to obtain measurements of efficiency of the analyzed regions, and to propose
corrective steps to achieve efficiency for inefficient HS. Moreover, the super-efficiency
measurement is shown for a constant and a variable scale.
Results
The results show that there are three groups of AC, first a group composed by six HS that are
globally efficient, a second group composed by eight HS that are globally inefficient, and a
third group composed by three HS that are efficient in some terms and their efficiency can be
improved.
Conclusions
It is concluded that DEA is an appropriate method for evaluating efficiencies of health
systems and giving the adjustments for the application of economic, social and organizational
policies to improve their efficiencies.

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 DEA-Like Efficiency Ranking of Regional Health Systems in Spain
Marianela Carrillo & Jesús M. Jorge

Abstract
The last decades have witnessed an increasing international concern in assessing how
efficiently health care resources are used in producing health. At a country level, comparing
the efficiency of regional health systems and ranking the regions accordingly promotes
transparency policies and represents an important incentive for the design and
implementation of specific programs aimed at improving the quality of health care services
within the country. The use of data envelopment analysis (DEA) as a tool for efficiency
analysis in the health sector is well-established, but its use with a ranking purpose is
discouraged due to lack of discrimination and comparability issues. Using data from the
competent health authority in Spain, the purpose of this study is to assess the efficiency of the
regional health systems in Spain and identify those regions that are using their health care
inputs more efficiently than others, given the observed level of health outcomes. To this aim,
a DEA-based model that operates under a common weights basis is used in order to improve
discrimination and establish a common scale for a proper comparison of the regional health
systems in Spain that can be subsequently ranked by their efficiency score.

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Secondary Data Analysis
 Overview of the Spanish healthcare system
Spain has a high-quality healthcare system, guaranteeing universal coverage for all residents.
Healthcare in Spain consists of both private and public healthcare, with some hospitals
(hospitales) and healthcare centres (centros de salud) offering both private (privado) and state
healthcare services (asistencia sanitaria pública).
Around 90% of Spaniards use the public healthcare system, which is called the National
Health System. However, it is very decentralized with service delivery organized at regional
level. The system is overseen by the Spanish Ministry of Health, which develops policy and
oversees the national health budget.
The Spanish National Healthcare System ("Instituto Nacional de la Salud"), founded on
Spain's General Healthcare Act of 1986, guarantees universal coverage and free healthcare
access to all Spanish nationals, regardless of economic situation or participation in the social
security network.
In 1998 the Sistema Sanitario Público (public health service) brought in an official mandate
for both doctors and patients outlining the service to which they are entitled, explained in the
Carta de Derechos y Deberes (Charter of Rights and Obligations).
Management
The national system has been decentralised since 2002, which has given the regional
healthcare authorities the autonomy to plan, change and upgrade the infrastructure, leading to
enormous development in the healthcare technology scenario, especially in the usage of
information technology. The reforms, which regionalised the system, were implemented in
order to provide greater and equal access to the population, thus avoiding the concentration of
health services in urban areas. This has also improved response time and increased the
participation of the target community in the development and management of the national
healthcare system at regional and local levels.
The current system consists of three organisational levels:
1. Central (Organizacion de la Administracion Central)
The Ministry of Health (Ministerio de Sanidad y Consumo), the state's central administration
agency, is in charge of issuing health proposals, planning and implementing government
health guidelines, and coordinating activities aimed at reducing the consumption of illegal
drugs.
2. Autonomous Community (Organizacion Autonomica)

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Each of Spain's 17 Autonomous Communities (Comunidades Autonomas) is responsible for
offering integrated health services to the regional population through the centers, services and
establishments of that community.
3. Local (Areas de Salud)
The "areas de salud" are responsible for the unitary management of the health services
offered at the level of the Autonomous Community and are defined by taking into account
factors of demography, geography, climate, socioeconomics, employment, epidemiology and
culture. To increase operability and efficiency, the "areas de salud" are subdivided into
smaller units called "zonas basicas de salud".
The Inter-territorial Board of the National Health System (CISNS) is responsible for the
coordination, cooperation and liaison among the central and autonomous region public health
administrations. The board is chaired by the National Ministry of Health and the members are
the Regional Ministers. It approves the national catalogue of services that must be provided
by all regional health services (cartera de servicios communes). The catalogue of is divided
into sections including primary care, specialised care, supplemental care, and pharmacy.
Primary Healthcare Services
Primary Healthcare services are available within a 15-minute radius from any place of
residence. The main facilities are the healthcare centres, staffed by multidisciplinary teams
comprising of general practitioners, paediatricians, nurses and administrative staff, as well as,
in some cases, social workers, midwives and physiotherapists. The principles of maximum
accessibility and equity mean that community primary healthcare also provides home care,
whenever necessary and also deal with health promotion and disease prevention.
Specialist care is provided in specialist care centres and hospitals in the form of outpatient
and inpatient care. Patients having received specialist care and treatment are referred back to
their primary healthcare doctor, who assumes responsibility for any necessary follow-up
treatment and care, ensuring the provision of continuous care under equitable conditions,
irrespective of the patient's place of residence and individual circumstances.
Private Healthcare
Private healthcare insurance for treatment at private hospitals and clinics is not widespread
and mainly used to avoid the sometimes long waiting lists to see specialist doctors in the
public healthcare system. Only 10 percent of the population has voluntary private insurance
although some private services are contracted by the public sector. Only in Catalonia, due to
historical reasons, there are a large number of non-profit, semi-public entities. Private
healthcare companies often offer quicker service to patients but also valueadded services such
as private rooms, express mailing of test results and keeping patients informed via email and
SMS messages.
Funding the System
The Spanish healthcare system is principally funded through taxation. The country's total
healthcare expenditure, amounts to 88,828 million euro, which accounts for 8.5 percent of the

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GDP. Public healthcare expenditure accounts for 6.1 percent of GDP and represents an
expense per inhabitant of 1,421 euro. The central government provides financial support to
each region based on population and demographic criteria.
Healthcare Resources
The National Health System has 2,914 health centres and 10,202 local clinics providing basic
healthcare services to the local population. In 2009 there were 804 hospitals operating in
Spain. The National Health System has 315 hospitals, equipped with 105,505 beds, and four
Ministry of Defence's hospitals contributing with 995 beds. The remainder 465 hospitals are
privately run and have 53,013 beds, which totals to 160,981 beds installed in Spain's
hospitals. Public hospitals are generally much larger than private hospitals and deal with a
much higher number of patients.
Excluding dialysis equipment, computerised axial tomography (CAT) is the most widespread
high technology in hospitals and dependent facilities, with a total of 677 units and a ratio of
14.8 per million inhabitants. Magnetic resonance follows with 438 units and a ratio of 9.6 per
million inhabitants. The number of mammography units dependent on hospitals totals 492.
There are 4.7 physicians per 1,000 inhabitants and annually they attend to more than 273
million medical consultations per year in primary care.
Healthcare Challenges
Spain has among the world's healthiest people with an average life expectancy of 81, one of
the highest in the EU. The incidence of heart disease in Spain is among the lowest in the
world, however, skin cancer is one of the highest.
Spain also takes a different view to rehabilitation, convalescence and terminal illness, leaving
care in these cases usually to the relatives, meaning that are very few public nursing and
retirement homes. This may prove one of the future challenges, as there is an increasing
potential demand for social support services and benefits by the dependent population, and by
carers.
However, one of the principal problems in Spain remains the limited coordination between
the Autonomous Communities, which increases disparities in services and quality of care
between the regions. Although the national system is overseen by the Ministry of Health and
Consumer Affairs (Ministerio de Sanidad y Consumo) and coordinated by the Inter-territorial
Board they focus more on long-term policies and cooperation and the responsibility of
healthcare delivery lies with the individual regions.
Numerous projects to improve national cooperation have been implemented by the Spanish
Ministry of Health such as the 'ep- SOS' (European patients Smart Open Services) pilot
project, which aims to develop a practical framework and an ICT infrastructure that will
enable secure access to patient health information, particularly with respect to basic patient
summaries and ePrescriptions between different European healthcare systems. This should
improve communication between Spanish regions and encourage cooperation.

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  Healthcare in Spain
Spain ranks 19th on the 2018 Euro Consumer Health Index and receives praise for its
improving health outcomes. On the other hand, poor accessibility and over-reliance on the
private sector remain problematic.

 Who can access healthcare in Spain?

State healthcare is free of charge to anyone living and working in Spain. However, on some
of the Spanish islands you may have to travel to find a state healthcare provider. As the
Spanish healthcare system is decentralized, you will need to check the conditions in your own
area for using healthcare services.

 Healthcare costs in Spain

Spanish health care spending accounts for around 9% of annual GDP, making Spain the 13th
biggest healthcare spender out of EU/EFTA nations. Spending works out at just over €2,000
per person. However, healthcare expenditure has increased in recent years and there has been
more of a reliance on private sector provision.
Despite this, most public healthcare in Spain remains free. Residents only need to pay a
proportion of prescription charges if they are making regular public health insurance
payments in Spain. They also have to pay for certain specialist medical procedures and may
need additional private insurance coverage.
Social security contributions fund the Spanish state healthcare system. Each region of Spain
takes individual responsibility for a health budget, which is ultimately allocated by the central
government.

 Health insurance in Spain

Health insurance in Spain is covered by Spanish social security payments, which are made by
all employees and self-employed workers. Spouses and children of workers also receive
coverage.
Certain other groups such as pensioners and those receiving benefits can also register for
healthcare if they are residents. They can do this even if they haven’t paid into the health
insurance scheme. There is also a discount state contribution scheme for low earners and
those out of work called the convenio especial.
Those not covered by state insurance or the EHIC card will need to take out private medical
insurance. See our guide to health insurance in Spain for more information.

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  Doctors and specialists in Spain
Doctors in Spain work out of either private practices or health centers. They offer both
private and state healthcare so be clear which type you want. You can choose your own
doctor in Spain. They can be found via your local healthcare authority.
If you want to be seen by a medical specialist in Spain, you will need to have a referral from
a family doctor. Bear in mind that waiting times can be long for highly prescribed analyses or
certain specialist services. If you have private health insurance, you will be able to see a
specialist much faster than going through the public system.

 Women’s healthcare in Spain

The standard of women’s healthcare facilities in Spain is generally good. However, it can
vary across the regions, with more available in urban environments. Pregnant women in
Spain have access to gynecologists and midwives through either public or private provision.
Most births take place in a hospital, although home births are becoming popular.
Contraception is widely available in all regions. You can buy condoms in pharmacies or
supermarkets, but you need a prescription for birth control pills in most areas. You can
acquire emergency contraception without a prescription.
There are clinics located across the country, which offer free STD tests and sexual health
information and advice. Cancer screening programs are administered by the regional
autonomous communities for breast cancer and cervical cancer.
Abortion has been legal in Spain, during the first three months of pregnancy, since 2010.
Terminations are only permitted after this under specific circumstances, such as if there is a
serious risk to the life or health of the mother.
For comprehensive information about women’s health in Spain, see our guides to women’s
healthcare and to having a baby in Spain.

 Children’s healthcare in Spain

Children in Spain have free healthcare coverage under their parent or guardian’s insurance.
This includes free dental care and access to pediatric services until the age of 15.
There are many specialist services across the country, which cater specifically for children’s
needs. This includes mental healthcare through child psychologists and psychiatrists. Public
services are good, although private healthcare is an option for those in regions where specific
facilities may be lacking.

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There is a national vaccinations program for children in Spain. Vaccinations are available
against a number of conditions including: Hepatitis B; Polio; Tetanus; Measles, mumps, and
rubella (MMR); Diphtheria
More information can be found in our detailed guides to children’s healthcare in Spain and
vaccinations in Spain.

 Visiting the dentist in Spain

The Spanish healthcare system does not cover dental care in Spain, unless you are aged under
15 or require emergency treatment. You will need to pay for dental treatment unless you have
private health insurance. Dentists in Spain will typically require payment upfront.

 Hospitals in Spain
In an emergency you can go straight to a hospital A&E or ER (Urgencias). If you want to get
any other type of hospital treatment, you will need a referral from a doctor. There are public
and private hospitals in Spain. Only the public hospitals provide free treatment. Some
hospitals offer both private (privado) and state healthcare services (asistencia sanitaria
pública), so make sure the staff knows which service you want.
When you go to a Spanish hospital you will need to show your social security card or proof
of private insurance. You can find out more information and see a list of hospitals in our
guide to hospitals in Spain.

 Health centers and health clinics in Spain

Primary healthcare in Spain is delivered through GP surgeries a (médico de cabecera) and
health centers (centro de salud or centro de asistencia primaria or CAP). Health centers are
located in every region and are staffed by multidisciplinary teams comprising of GPs,
pediatricians, nurses, gynecologists, and physiotherapists.
Health centers in Spain tend to have around six GPs. You may not see the same doctor each
time you visit, although in some centers you can book to see a specific doctor. There are also
a number of specialist health centers providing specialist care in Spain.

 Pharmacies in Spain
You can take a prescription to any pharmacy (farmacia). Look for a shop with a large green
cross sign outside. Pharmacies are usually open on Monday to Friday from 9:30–14:00 and
17:00–21:30, and Saturdays from 9:30–14:00. There is usually a notice on the pharmacy
window or door with details of the nearest 24-hour pharmacy (farmacia de guardia) – or you
can find a list of pharmacies online.

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  Pharmacy in Sevilla
Spain operates on a co-payment system for prescription medicines. Residents have to pay a
non-refundable percentage of medicine costs. How much you pay depends on your personal
situation, and the guidelines are as follows:
If you are of working age, you pay between 40–60% of costs depending on your annual
income;
Pensioners with an annual income of less than €100,000 pay 10% of costs;
Sufferers of chronic or serious illnesses pay 10% of costs, with a cap on each medication.
Registered pharmacists can also provide health consultations and guidance on health matters.

 Mental healthcare in Spain

Mental healthcare provision in Spain falls short of what is available in terms of physical
healthcare services. According to EU figures, there are 8.1 psychiatrists, 5.7 psychologists,
9.7 mental health nurses, and 32.2 psychiatric hospital beds per 100,000 inhabitants. This is
below the EU average.
These figures are reflective of the general gap in mental health services in southern Europe,
compared with other parts of the continent. That said, Spain has implemented a Mental
Health Strategy which aims to improve service delivery and coordination. The Confederation
of Mental Health in Spain works closely with the Ministry of Health to improve service
quality and integrate the Autonomous Communities.
If you need mental health treatment in Spain, you will typically receive care through your GP
or at a health center in the first instance. Those with serious or ongoing illnesses will be
referred for specialist treatment, most of which is provided at community mental health
centers. They can also access private treatment such as psychotherapy. However, state health
insurance will not cover this, so you will need private coverage if you don’t want to pay the
full costs.

 Other forms of healthcare in Spain

Alternative and complementary therapies, including homeopathy, acupuncture, reflexology,
and chiropractic treatment, are currently available in Spain. According to Spanish law,
alternative medicine should be practiced only by those with full medical qualifications. Some
treatments are available in health centers. However, the Spanish government recently
announced plans to eradicate alternative treatments from public centers.

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Although some treatments such as homeopathy are widely available in Spain, public health
insurance does not cover complementary therapies. Some private insurance companies will
cover it, but you will usually have to select this as an add-on and pay a higher rate.

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An Overview of Private Health Insurance in Spain
Generally, you do not need private health insurance in Spain but knowing how it works is
always a good idea. If you would like to avoid the delays of public healthcare, or if you
simply prefer to have private health insurance, there are many insurance types and plans to
choose from.
However, it is important to keep in mind that you need health insurance to enter Spain. Most
visa applications require proof of healthcare. It is advisable to either have travel health
insurance from your home country or, better yet, apply for a private healthcare plan in Spain.
The insurance companies in Spain will know how the local healthcare system works and
which procedures are covered with your plan.
How to Get Private Healthcare in Spain?
Anyone can get private health insurance in Spain. There are no specific requirements. Opting
for it has manybenefits such as allowing quicker access to specialists, the possibility of
choosing English-speaking healthcare providers, and overall more comfortable hospitals and
medical centers.
In general, private insurance is used by around 19% of Spanish residents. Many Spaniards
choose to add a private plan to their public healthcare to access quicker and more extensive
treatments. A lot of health insurances even offer both public and private provisions. Some job
contracts may include private health insurance, so check with your employer before signing
with an insurance company.
Private healthcare plans are especially popular among expats. Mainly because in 2013, a law
that regulates the Spanish healthcare system was modified and a lot of healthcare services
became inaccessible for expats. Moreover, expats are required to show proof of health
insurance when applying to visas. If you cannot find work right away, you need to
demonstrate to the government that you won’t cost them a lot of money in case of an
accident.
Types Private Health Insurance Providers
When choosing private healthcare insurance, it is advisable to make your decision based on
the coverage and package each provider offers, and not solely on the cheapest plan. This
could turn out costly in case of emergencies, if your plan does not cover everything.
You can choose from a variety of health insurance plans in Spain: from low-cost plans with
few services to more extensive health insurance coverage. Health insurance plans vary
depending on the insurance companies. You can check prices and deals on their individual
websites and easily sign with an insurance plan online.
The most popular Spanish Private Insurance providers are:
Sanitas
Adeslas

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Asisa
If you are unsure which provider to choose, you can always check out the websites Rastreator
and Acierto. Both compare different private plans and options and help you find the best one
for your individual needs.
Average Cost of a Health Insurance in Spain
Are you wondering how much private health insurance is? The cost will depend on your age,
gender, and any pre-existing conditions. The average cost of health insurance is typically
from 100 to 200 EUR (112 to 224 USD) per month. You can also find plans for as low as 50
EUR (56 USD) per month with some of the bigger insurance companies. Primary care
consultations and specialists in the private sector usually cost between 100 and 150 EUR (112
to 168 USD) per consultation.
For those who prefer to use private health insurance to supplement services not covered by
public health insurance, there are basic, affordable plans that include services like dental care
and blood tests, but exclude surgeries and hospitalization.
With most private plans, you will be asked make co-payments upfront for services. The rest
of the treatment will usually be covered by your insurance. However, you may still receive
additional bills via the mail even after your co-payments, so always check which specific
procedures are covered by your insurance plan. You may also have some triangulation
between your insurance provider and hospitals or medical centers, so expect to play some
part in the communication between these services.

How to Find Doctors or Dentist

If you are at the stage in your relocation, where you are wondering how to find a doctor or
dentist, then congratulations, you have come very far. As part of the public healthcare system
in Spain, you are entitled to a family doctor who can offer consultations free of charge. You
just need to register with your local clinic and bring along your registration documents (such
as the empadronamiento from when you first registered your place of residence). A family
doctor will then be assigned to you. These are general practitioners who can refer you to a
specialist in the public healthcare system whenever needed.
In general, if you need to find a doctor or specialist, you should not have much difficulty.
You can easily find private practices if you search for médicos near you. Dental services are
not covered by public healthcare, so you will need to look for a private dentist. To find a
dentist, you can look up dentistas online. You can also search for reviews and compare prices
on specialized websites such as [Link].
The first dentist appointment and dental check-up are often free of charge, but any procedures
thereafter are charged. The prices are set by each medical practice. For reference, a filling
tends to cost around 60 EUR (67 USD).
How to Find Specialists

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If you need a specialist, your general practitioner (family doctor) will refer you. This referral
is important for insurance purposes. If you visit a specialist without a referral, your insurance
may not cover any of the costs. You also run the risk that a specialist may not treat you
without a referral. If you want to look for a family doctor or a specialist, you can check the
medical directory.
Keep in mind, whenever you request public healthcare services, be sure to carry your
personal health card with you (tarjeta sanitaria individual).
What are the Waiting Times to See a Doctor in Spain?
You can expect long wait times and delays with public healthcare services in Spain. On
average, you may have to wait around 57 days to see a specialist. The longest delays are for
traumatologists (68 days) and ophthalmologists (64 days).
For surgeries, the average national wait time is 93 days. However, these delays vary from
region to region. Madrid, La Rioja, and the Basque Country tend to have the shortest waiting
periods for surgery: 48 days. The Canary Islands, Castilla-La Mancha, and Catalonia have the
longest wait times: around 140 days.
Hospitals in Spain
The public healthcare system covers emergency care, which includes going to the hospital in
case of an emergency or having to undergo surgery. Public and private hospitals in Spain are
ranked among the best in the world. The only downside to public healthcare in Spain is the
long waiting lists for specialists and non-emergency care.
Ambulance Services in Spain
To call for emergency assistance (ambulance, police, fire department) in Spain, you will need
to dial the number 112. The first responders are trained staff among of which at least one is
an emergency physician, an emergency nurse, an emergency medical technician, and a
patient transport assistant. The Spanish emergency medical services consist of a two-tiered
response system, Advance Life Support with physicians and nurses, and Basic Support with
technicians. After assessing you on site, the staff will transport you to the nearest hospital.
Emergency care is generally covered by public health care in Spain. If you have private
healthcare or are not yet eligible for Spanish healthcare, you will probably need to pay for the
services yourself and send an invoice to your healthcare provider.
Where to Get your Medication in Spain
Over-the-counter medication in Spain can be purchased in pharmacies. Prescription
medication will need to be prescribed by your physician and can later be obtained at a
pharmacy.
Costs for Prescription Medication in Spain

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There are prescription fees in Spain. Children are free of charge. Pensioners who receive a
state pension are only charged 10%. Employed Spanish citizens pay the highest rate, with a
charging fee of 50%.
Health care spending
The containment of health care expenditure is one of the major challenges facing public
policymakers in the developed countries. Expenditure on health care is driven by a complex
set of interrelated demand and supply side factors. In Spain, several factors have clearly
contributed to the continued growth of health spending.
Demand and use of services
In the last years, it has been a progressive demand and use of health services due to the aging
of the population, the chronification of diseases and the increasing medicalization of the
population. The aging of the population is considered one of the most important factors in all
developed countries and, as suggested by some authors, may be responsible for around 20%
of the increase in health spending. In spite of this widespread belief that links the average
health care expenditure to the age of an individual, several studies show that the demand for
and use of health care depends ultimately on the health status and functional ability of
citizens. The population of Spain is highly aged and we know that almost 80% of the
consumption of health resources occurs in individuals above 65 years old. Also of remark,
Spain is one of the European countries where individuals visit the doctor more often: there
are 7.5 visits per capita per year, whereas in Sweden the rate is 2.9 visits per year. Another
factors that have also contributed to raised health care spending are unhealthy lifestyles,
particularly obesity. Spain is one of the European countries with a higher percentage of obese
individuals.
Technology and medical progress
On the supply side, technological developments and constant evolution in the state of the art
of medical science are variables that have decisively contributed to improving public health
but also major factors affecting the level and rate of change in health care spending. Medical
technology can be defined as the drugs (pharmaceuticals and vaccines), medical equipment,
health-care procedures, supportive systems, and the administrative systems that can tie all
these disparate elements together.
Pharmaceutical expenditures
In the recent published OECD health statistics report, the current expenditure on
pharmaceuticals (prescribed and over-the-counter medicines) and other medical non-durables
in Spain reached the 17,9% of current expenditure on health (1,6% above the OECD
countries average, year 2014). In terms of impact on GDP (year 2013), pharmaceutical
spending represented 1.6% of GDP, ranging from 0.5% in Denmark to 2.8% in Greece (year
2013, 1,4% average, OECD countries).
In most OECD countries, pharmaceutical expenditure containment policies have been
introduced in the last years, generally based on price controls, the number of prescriptions,

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the introduction of generic medicines and increasing costs assumed by users. In Spain, it has
been a reduction in pharmaceutical expenditure, which fell by more 6% in real terms in 2011.
Spain has introduced a series of measures to reduce spending on pharmaceuticals, including a
general rebate applicable for all medicines prescribed by national health service physicians in
2010, and mandated price reductions for generics and increase in co-payments in 2012. The
share of the generic market also doubled in Spain between 2008 and 2012, to reach 18% of
the total pharmaceutical market in value (40% in volume).
Finally, a new debate is ongoing regarding the impact of new high cost, specialty medicines
targeting small populations on the long-term sustainability and efficiency of pharmaceutical
spending.
Efficiency of the model
Improving health care system management efficiency may be an alternative to be considered
in containing health care expenditure. The application of efficiency concepts to health care
systems is challenging. Measurement of productive efficiency is based on the relationship
between output produced and inputs required for production. This measurement is not free
from difficulties. In the particular case of health care efficiency, despite even the definition of
output is not exempt from controversies, the literature appears to have reached a consensus
on life expectancy as the main output in the health care production function. OECD [2010]
estimates that average life expectancy could increase by about 2 years for the OECD as a
whole, if resources were used more efficiently. Although the results depend on the indices
taken in account, there are significant differences across countries in health care management
efficiency levels. In an analysis of efficiency estimates of different health care systems, Spain
consistently scores among the top seven performers in most of the models and is clustered in
the group of countries with highest average efficiency scores. The prevailing model in Spain
is salaried professionals and despite the difficulties in applying efficiency concepts to health
systems, there is a considerable body of evidence on the pervasiveness of inefficiency in the
health sector. Several factors have been related to the lack of efficiency, directly influencing
the overall growth of health spending.
Factors influencing inefficiency in Spanish health system
1. Factors influencing inefficiency in Spanish health system
2. Bureaucratic and politically colonized model
3. Poor integration between healthcare levels
4. Administrative formalities: i.e., prescription renewal
5. Absence of management autonomy of institutions
6. Lack of incentives to promote efficiency
7. Lack of instruments to recognize excellence among professionals

Spain’s healthcare system in recovery after Covid-19

Travellers to Spain and expats living in the country will find the Spanish healthcare system
offers a range of quality public as well as private services. The Spanish National Healthcare

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System, Instituto Nacional de la Salud, is principally funded by taxation, guaranteeing
universal healthcare access to Spanish nationals and most Spanish residents. Under this
system, basic services are free, but patients sometimes need to contribute, for example,
paying a proportion of the cost of prescriptions. Dental and ophthalmological services are not
covered by this system.
The Spanish healthcare system is increasingly decentralised to the 17 Autonomous
Communities, with the ability to plan, change and upgrade their health infrastructure
according to the needs of local residents.
Although the Spanish population is among the world’s healthiest, with an average life
expectancy of 83 years and a low rate of heart disease, issues sometimes arise over co-
ordination and varying standards of care between the autonomous communities. To improve
this, efforts are underway to increase shared access to digital patient health information.
Private healthcare is less widely used by Spanish nationals, but is preferred by those looking
for value-added services such as private rooms and keen to avoid the sometimes-long waiting
lists for specialist doctors.

Conclusion
In terms of socio-economic development and in relation to similar countries, the Spanish
health system is generally comparable in almost all dimensions: population coverage, global
equity, access equity, technical quality and economic efficiency.
The Spanish national health system is in itself a great success of Spanish society, for its
technological capacity and human capital, for the accessibility of its service network, for
offering access to the latest advances in medicine and medical technology. For the entire
Spanish population, the national health service represents security and tranquility in case of
illness or accident. All these characteristics have a great consensus and social support, only
clouded by the surprisingly low priority that health—and to a lesser extent other public
services—have on the Spanish political agenda. The sustainability of the system is under
debate. There are basically three ways to guarantee the financing of a quality public health
system with universal coverage and free of charge: to increase the efficiency and
effectiveness of the health provision system, prioritize health spending in relation to other
public policies and/or increase income taxes for that purpose.

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 Indian Healthcare System

Understanding How India’s Healthcare System Works

India is home to one of the world’s largest healthcare systems. Despite huge challenges, the
country provides free, albeit basic, healthcare to over one billion people. That’s no small
accomplishment! It’s also enjoyed significant triumphs, such as eradicating polio in 2011.
Additionally, communicable diseases in India fell by a remarkable 50% between 1990 and
2016. These are tremendous feats for the world’s second most populated country. However,
behind these achievements are some harrowing statistics. The country ranks 112 out of 191
countries on the World Health Organization’s ranking of global healthcare systems. Infant
mortality remains unacceptably high, approximately seven times that of the United States.
India’s healthcare system presents many serious challenges for both residents and visitors.

Overview of the Indian Healthcare System

In theory, at least, India has universal healthcare. In some states, as much as 90% of the
public relies on government-run hospitals, which are free. However, as critics quickly point
out, India’s universal healthcare is not exactly universal in nature. There are significant gaps
in care based on gender, social class, and geography.
By law, providing healthcare services is a state responsibility. States are additionally charged
with addressing public health, nutrition, and standards of living. Just how well they succeed
in their undertakings varies tremendously. Corruption is widespread, both among government
and healthcare officials. As a result, public facilities are underfunded. Standards of care are
basic (at best) and sometimes abhorrent (at worst). Supplies that are supposed to be
guaranteed, such as free medications, are often unavailable. Unsurprisingly, wait times are
significant. Patients sometimes resort to bribery in an effort to receive timely care.
However, Indian patients have reason to be hopeful. Some 150,000 Health and Wellness
Centres (HWCs) have been established to improve timely healthcare access. This has been
achieved in part by transforming existing Sub Health Centres to deliver comprehensive
primary health care.

Who is Eligible for Healthcare Coverage?

Unless you are among India’s poorest people, there is no public health program to qualify for.
Indian citizens receive treatment at no cost at public hospitals. Expats and tourists can also
use these same facilities but they will have to pay out of pocket. For minor medical concerns,
this can cost as little as just a few dollars.

Healthcare Options for Expats and Foreigners in India

The vast majority of expats opt to carry private international health insurance in India and be
treated in private facilities. This isn’t just because public facilities are very basic in nature.
It’s also because there are limited resources. An expat who receives care in a public facility is
just one more person causing delays and congestion.

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For those who do opt to use public facilities (or who no other choice based on their location),
you can expect a registration fee in addition to the treatment cost. Those admitted overnight
also pay room charges. Most public hospitals offer different levels of accommodations
(common classifications include “deluxe,” “deluxe with AC,” or “super deluxe”.) Generally,
the better the room, the happier the patient. Expats who find themselves in this situation
should request the best room classification that they can afford.

Costs of the Healthcare System

India’s healthcare system is funded through government taxation. In 2019, the government
was spending $36 billion on healthcare annually, or roughly 1.23% of its GDP. When out-of-
pocket costs that patients spend for private healthcare are taken into account, the country’s
total healthcare GDP equals 3.6%.
India has the largest private healthcare system in the world. It’s so pervasive that only about
20% of all healthcare services fall under the purview of public funding. Unlike many other
countries, it’s not just wealthy citizens using private facilities. Much of the demand is driven
by financially precarious citizens who can ill-afford to go to a private clinic. However, they
feel they have no other choice in order to receive timely care.
In an effort to relieve the financial and healthcare burdens of India’s most vulnerable people,
the government introduced a new national health protection plan in 2018. Called Ayushman
Bharat, it targets the poorest half of India’s population, some 500 million people. Patients are
allocated $7,200 in annual coverage to put towards the cost of care at private hospitals. The
country’s newly developed Health and Wellness Centres are an additional core component of
Ayushman Bharat, as their focus is on making comprehensive primary care more accessible.

The Differences Between Private and Public Care

While a significant proportion of India’s population makes use of private healthcare facilities,
very few carry private health insurance. Just 17% to 25% are thought to have this form of
coverage. As there is no regulatory authority in India to oversee private healthcare providers
and insurance companies, costs can be high. The majority of local patients opt to pay a la
carte for services as they need them. Sadly, in some cases, patients take on significant debt in
order to afford care.
The standard of healthcare in private facilities ranges from adequate to world-class. Those
private facilities which mainly target local working-class residents differ greatly from those
targeting expats and wealthy locals. In all cases, patients can expect comfortable facilities
with greater personal privacy. Facilities are cleaner, more organized, and more up-to-date
than public ones. Wait times are shorter and there is a wide variety of specialists on staff.
And, at the high end of the scale, the swankiest private hospitals can resemble hotels. They
feature large, comfortable rooms, good food, and personalized care.
Perhaps unsurprisingly, India is a world leader in medical tourism, thanks in large part to the
standard of care found at the country’s top private hospitals. Uninsured patients from
countries such as the United States can travel to India for procedures such as joint
replacement and pay just a fraction of the price they’d face at home.

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Rural Healthcare in India
The state of healthcare in rural India is problematic, to say the least. 74% of India’s doctors
serve urban areas. In India’s vast rural territories, doctors are very sparse indeed. This
statistic seems unlikely to change significantly. Doctors are frustrated by the poor housing,
education options, and infrastructure in rural areas. Then there are the hospitals themselves.
There are half as many beds compared to urban facilities. Additionally, rural hospitals are
perpetually the last to receive new equipment. This all adds up to devastating results for local
healthcare. For instance, children under five in certain rural areas have higher mortality rates
than those in urban environments.

Lack of infrastructure
India has been struggling with deficient infrastructure in the form of lack of well-equipped
medical institutes for quite a while now. To add to it, the rate of building such medical
teaching or training facilities remains less as compared to the need of the hour.
For a considerable time, the government regulation mandated that private medical colleges
must be built on at least five acres of land. As a result, quite a few private colleges were built
in rural areas, where it became quite difficult to recruit adequately qualified, full-time doctors
due to lack of proper living conditions, besides low pay scales.
It is only now that the newly-constituted National Medical Commission (NMC) has put
forward the idea to do away with the requirement of minimum five acres of land for setting
up a medical college.
Further, the commission has proposed to curtail the minimum number of beds required as a
proportion of the number of seats in the college.
In addition, the new regulations have also laid down the requirements for lecture theatres,
libraries, laboratories, minimum bed requirement of the attached medical college, and
location of faculty offices and accommodation of students.

Shortage of efficient and trained manpower

One of the most pressing problems in India remains a severe shortage of trained manpower in
the medical stream, this includes doctors, nurses, paramedics and primary healthcare workers.
The situation remains worrisome in rural areas, where almost 66 per cent of India’s
population resides.
The doctor-to-patient ratio remains abysmally low, which is merely 0.7 doctors per 1,000
people. This is compared to the World Health Organisation (WHO) average of 2.5 doctors
per 1,000 people. Improving this situation continues to remain a long-term process.
The issue can be suitably addressed by increasing the capacity of existing teaching and
training institutes while adding new ones in the long run.

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Unmanageable patient-load
Even prior to the outbreak of the Covid-19 pandemic, healthcare facilities had been feeling
the strain due to unmanageable patient-load. Moreover, serving a population of 1.4 billion
remains a Herculean task in itself when it comes to suitably managing healthcare facilities.
There is a need to adopt technology wherever possible to streamline the operational and
clinical processes for healthcare facilities in order to manage efficient patient flow. In
addition, there is the challenge to think beyond the obvious and promote virtual care
protocols, and telehealth services, which can be leveraged to reduce the patient-load burden
to a large extent.

Public health policy and proactive healthcare

The latest National Health Policy (NHP) 2017 highlights the ‘Health for All’ approach to
provide assured healthcare for all at an affordable cost. However, there is scope to do much
more under the NHP 2017. Ideally, the public health policy needs to be focussed towards
proactive healthcare, not reactive healthcare.
Besides, in the case of the government’s Ayushman Bharat scheme, the Pradhan Mantri Jan
Arogya Yojana (PM-JAY), the universal health insurance scheme, has received considerable
attention and resources than the health and wellness centres (HWCs) component. This
asymmetry needs to be suitably addressed for the growth of healthcare in the future.

High out-of-pocket expenditure remains a stress factor

While public hospitals offer free health services, these facilities are understaffed, poorly
equipped, and located mainly in urban areas. It is a known fact that accessible and affordable
healthcare in the public sector can considerably reduce the rise in dependence on private
institutions. However, governmental facilities leave no alternatives but to access private
institutions and incurring high out-of-pocket expenses in healthcare. Most health services are,
therefore, provided by private facilities, and 65 per cent of medical expenses in India are paid
out of pocket by patients.
A possible solution to address the issue could be to increase the adoption of health insurance.
In this regard, the government and private institutions both need to work together. Adoption
of digital insurance processing solutions integrated with the healthcare ecosystem for faster
turnaround time for insurance processes will also motivate adoption of health insurance.
What primarily ails the healthcare system is that there has been a general lack of focus on the
vertical from the government. For years now, knee-jerk reaction work is being witnessed
towards the improvement of quality of service.
To sum it up, there is an urgency to make healthcare service and service providers more
transparent operationally. This will help ensure people and processes can be made easily
accountable to provide better healthcare services. It is only then that the healthcare system
can breathe a bit easier.

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Conclusion:
India has been focussing on providing comprehensive care to mother and child. It has framed
policies that allow the design and implementation of programs on newborn care in an
inclusive manner. However, looking at the pace of achievements of the targets so far and
future targets, it needs to focus more on framing of the policies in terms of building capacity
of existing human resources, enhancing further allocation of finances dedicated toward
newborn care, identifying areas through operational research, which can enhance quantity
and quality of care for newborn care in India. The path is set and we need to operationalize
and move forward.

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 Primary Data Analysis
Thinking about the overall experience with the health care, how well organized
do you think it is?

 Analysis: Out of 210 people

186 found the healthcare system moderately organized.
16 found the healthcare system very well organized.
8 found the healthcare system poorly organized.

 Interpretation:
Consumer and community trust in health care providers and institutions is critical for optimal
health, as trust influences willingness to get crucial medical care, preventive screenings, and
mental health care. Trust between a patient and a health care provider is also linked to
improved patient experience, health outcomes, and the patient’s perception of the care they
receive.
According to the sample data, majority find the system moderately organized. Thus, this
clearly says that people are not completely satisfied with the overall efficiency and working
of the healthcare system and need it to be improved. They must have had bad experiences
with the management of hospitals which led them to choose the “Moderately Organized”
option but not so bad to choose the “Poorly Organized” option. Thus, Healthcare system of
India does need improvements in the overall efficiency and organization.

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Which type of hospital do you prefer for your healthcare?

 Analysis: Out of 210 people

164 people prefer Private Hospital.
46 people prefer Public Hospital.

 Interpretation:
While public hospitals offer free health services, these facilities are understaffed, poorly
equipped, and located mainly in urban areas. It is a known fact that accessible and affordable
healthcare in the public sector can considerably reduce the rise in dependence on private
institutions. However, governmental facilities leave no alternatives but to access private
institutions and incurring high out-of-pocket expenses in healthcare. Most health services are,
therefore, provided by private facilities.
This justifies majority of the surveyed respondents to choose private healthcare over public.
A way that the government could go about speeding up the process is by actioning its recent
health policy and partnering with the private sector, instead of fighting it. Private healthcare,
because of being a business unit, is highly efficient but not very equitable. The government
needs to view private healthcare as a "business", acknowledge its "business objectives" and
fill in the gaps to make it equitable. In better incentivizing and enabling private healthcare to
penetrate rural areas, the government could well capitalize on its "strategic purchasing" of
private healthcare units plan and start delivering on its mandate.

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Rate the overall healthcare system of India.

 Analysis: Out of 210 people

177 people responded with a rating 6 or above.
33 people responded with a rating 6 or below.

 Interpretation:
Healthcare comprises hospitals, medical devices, clinical trials, outsourcing, telemedicine,
medical tourism, health insurance and medical equipment. The Indian healthcare sector is
growing at a brisk pace due to its strengthening coverage, services and increasing expenditure
by public as well private players. India's competitive advantage lies in its large pool of well-
trained medical professionals. India is also cost competitive compared to its peers in Asia and
Western countries.
That being said, majority of the people do believe that the overall healthcare system of India
is good by rating above 6. The 33 people rating below 6 must have had bad experiences with
hospitals, found the infrastructure bad, did not find the doctors qualified etc. Overall, this
question helps us understand how people think about the Indian Healthcare system and we
can conclude that majority people do find the system good but there is a scope for
development.

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What are the problems faced by the healthcare system according to you?

 Analysis: Out of 210 people

131 people think that the Healthcare System lacks funding.
122 people think that the Healthcare System lacks proper infrastructure.
22 people think that the Healthcare System has unqualified doctors.
45 people think that the Healthcare System is costly.
124 people think that the Healthcare System is poorly managed.

 Interpretation:
India has been struggling with deficient infrastructure in the form of lack of well-equipped
medical institutes for quite a while now. One of the most pressing problems in India remains
a severe shortage of trained manpower in the medical stream, this includes doctors, nurses,
paramedics and primary healthcare workers. The doctor-to-patient ratio remains abysmally
low, which is merely 0.7 doctors per 1,000 people. Moreover, serving a population of 1.4
billion remains a Herculean task in itself when it comes to suitably managing healthcare
facilities. There is a need to adopt technology wherever possible to streamline the operational
and clinical processes for healthcare facilities in order to manage efficient patient flow.
To sum it up, there is an urgency to make healthcare service and service providers more
transparent operationally. This will help ensure people and processes can be made easily
accountable to provide better healthcare services. It is only then that the healthcare system
can breathe a bit easier.

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Do you think India is ready for another pandemic like Covid -19?

 Analysis: Out of 210 people

120 people think that India is not ready for another pandemic.
100 people think that India is ready for another pandemic.

 Interpretation:
In India, some initial steps of caution and, perhaps, the fact that we are less connected to the
world, have so far saved us from an epidemic. Of course, there is the alternative hypothesis
that because of our low level of testing, we really don't know the real situation.
Unfortunately, we do have a history of being under prepared -- and often unprepared -- and
then struggle to rectify the situation. Our huge metros with enormous slums and cheek by
jowl living of families of four or more in one to two room tenements with shared bathrooms
(if any) is hardly likely to provide the environment for social distancing. And once a family
or two in a basti falls victim, will there be any means of stopping its spread? And then
overflowing into the next cluster?
According to the survey answered, little more than half believe that India will not survive
another pandemic situation which is completely justified. Yet, the other half believes that
India is ready for another pandemic. This shows the confidence of the public in the
Healthcare System.

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Healthcare system will improve to the required standards in the future years.

 Analysis: Out of 210 people

62 strongly agree that the Healthcare System will improve to the required standards in the
future years.
92 agree that the Healthcare System will improve to the required standards in the future
years.
51 are neutral about the fact that the Healthcare System will improve to the required
standards in the future years.
5 disagree that the Healthcare System will improve to the required standards in the future
years.

 Interpretation:
India is a land full of opportunities for players in the medical devices industry. The country
has also become one of the leading destinations for high-end diagnostic services with
tremendous capital investment for advanced diagnostic facilities, thus catering to a greater
proportion of population. Besides, Indian medical service consumers have become more
conscious towards their healthcare upkeep. Indian healthcare sector is much diversified and is
full of opportunities in every segment, which includes providers, payers, and medical
technology. With the increase in the competition, businesses are looking to explore for the
latest dynamics and trends which will have positive impact on their business. India's
competitive advantage also lies in the increased success rate of Indian companies in getting
Abbreviated New Drug Application (ANDA) approvals. India also offers vast opportunities
in R&D as well as medical tourism.

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To sum up, there are vast opportunities for investment in healthcare infrastructure in both
urban and rural India. This justifies the majority people’s response of agreeing or strongly
agreeing to the statement. The neutral option is chosen by the people to whom the pandemic
situation has made them skeptical about Indian Healthcare’s future.

How important do you think is the need of a good healthcare system?

 Analysis: Out of 210 people

172 think that a good health care system is very important.
34 people think that a good health care system is important.
4 people think that a good health care system is least important.

 Interpretation:
An efficient health care system can contribute to a significant part of a country's economy,
development, and industrialization. Health care is conventionally regarded as an important
determinant in promoting the general physical and mental health and well-being of people
around the world. Therefore, majority of the people think to have a good healthcare system is
necessary.

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Which type of hospital do you prefer for your healthcare?

 Analysis: Out of 210 people

164 people preferred private hospital for their treatment over public.
46 said that they preferred public hospital.

 Interpretation:
The results confirms that quality of care, accountability and various services are main reason
for patients’ preference in private hospitals. Great concern about the quality of healthcare
services in the country but since public hospitals are more economical therefore there are
some people who prefer public hospital even though they provide less facilities as compared
to private hospitals.

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Based on you and your family’s experiences getting medical care in India, how
easy or difficult have you found?

 Analysis: Out of 210 people

53 said that it was very easy for them to look for good healthcare.
132 said they found it easy.
21 said they found it difficult.

 Interpretation:
Although the majority of people found it relatively easier to get good healthcare service in
India, the emphasis here is that about 10% people are finding it difficult to get good
healthcare but primary healthcare is a basic right and every individual should receive
it..Therefore, the reason they are finding it difficult makes it a big issue.

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In the past 2 years, was there ever a time when you or your family member felt
that doctors, hospitals, recommended treatment, medical test that you thought
were unnecessary, or made a medical error, including giving you the wrong
drug or dose of medicine?

 Analysis: Out of 210 people

101 answered no.
62 answered yes.
47 answered maybe.

 Interpretation:
There is a common conception in the minds of people that the doctors give unnecessary
medication and tests because they feel that the system is corrupted, therefore as you can see
from the survey nearly more than 50% of the people do not trust the system and they selected
the options ‘yes’ and ‘maybe’.

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Experts Survey Analysis and Interpretation
Responses received from the questions asked to 15 doctors:
1. You work as a:

 Analysis:
6 doctors work in a Public Hospital
4 doctors work in a Private Hospital
3 doctors work in a Private Clinic
1 doctor works in a Pharmaceutical
1 doctor works in a pharma

1) Dr. Amitabh Kenny

Dr. Amitabh Kenny works as doctor in a private clinic is a physician, diabetologist and also a
cardiologist. He has a good review by his patients.

2) Dr. Swapnil Kenny

Dr. Swapnil Kenny is an orthopedician. He is currently working in a private hospital.

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 3) Dr. Vipul Manek
Dr. Vipul Manek is currently working in a public Hospital and he is also known for his sweet
and caring nature. He is a general physician with a MBBS degree.

4) Dr. Brijesh Manek

Dr. Brijesh Manek, he is a general physician with an MBBS degree. And works at a public
hospital for decades.

5) Dr. Mukesh dhadhich

Dr. Mukesh is a physiotherapist. Currently he is working in a private hospital.

6) Dr Parul Nema
Dr Parul Nema is a pathologist. She works in a public hospital in Shivpuri. Apart from this
she is also an assistant professor in Shivpuri Government college.

7) Dr Shubhum Choudhary
Dr Shubhum Choudhary is a biotechnologist. Currently he is working in a public hospital. He
is also head professor at Shivpuri Government College.

8) Dr. Uttam Choudhary

Dr. Uttam Choudhary is a general doctor in pediatrics. He works in a public hospital.

9) Dr. Madhavi chordia

Dr. Madhavi chordia is a pulmonologist. She has her own personal clinic.

10) Dr. Manu Maheshwari

Dr. Manu Maheshwari is a very successful neurologist. She is currently working in a private
clinic.

11) Dr. Sapna Kini

Dr. Sapna Kini is an Orthopedician with her MBBS degree. She works at a private hospital.

12) Dr Anand Nagori

Dr Anand Nagori serves his duty in a private hospital in Bhilwara. He is a dental surgeon by
profession.

13) Dr. Mahima hasija

Dr. Mahima hasija is an orthopedician by profession with an MBBS degree. She is currently
working at a public hospital.

14) Dr. Nitin Mulgaonkar

Dr. Nitin Mulgaonkar works in a pharmaceutical company.

15) Dr. Bhavna Mulgaonkar

Dr. Bhavna Mulgaonkar is also currently working in a pharmaceutical company.

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  Interpretation:
According to the responses received, majority of the doctors work in hospitals. This question
gives an idea of how to interpret the survey as we now know from which type of doctors the
responses are coming from. This will further help us to interpret what doctors in hospitals
opine versus the doctors in a private clinic.

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 2. Do you think Medical Colleges and Institutions in India offer good
quality education?

 Analysis:
11 doctors think that medical colleges and institutions do offer good quality education in
India.
3 doctors were doubtful whether medical colleges and institutions do offer good quality
education in India.
1 doctor thinks that medical colleges and institutions do not offer good quality education in
India.

1) Dr. Amitabh Kenny

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

2) Dr. Swapnil Kenny

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

3) Dr. Vipul Manek

The expert replied with a “maybe” meaning that they were unsure whether Indian medical
colleges and institutions do offer good quality education.

4) Dr. Brijesh Manek

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

5) Dr. Mukesh dhadhich

The expert replied with a “no” which says that they do not think that Indian medical colleges
and institutions do offer good quality education.

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6) Dr Parul Nema
The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

7) Dr Shubhum Choudhary
The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

8) Dr. Uttam Choudhary

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

9) Dr. Madhavi chordia

The expert replied with a “maybe” meaning that they were unsure whether Indian medical
colleges and institutions do offer good quality education.

10) Dr. Manu Maheshwari

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

11) Dr. Sapna Kini

The expert replied with a “maybe” meaning that they were unsure whether Indian medical
colleges and institutions do offer good quality education.

12) Dr Anand Nagori

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

13) Dr. Mahima hasija

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

14) Dr. Nitin Mulgaonkar

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

15) Dr. Bhavna Mulgaonkar

The expert replied with a “yes” indicating that they do think that Indian medical colleges and
institutions do offer good quality education.

 Interpretation:
Here, we can clearly say that almost all doctors are positive about the education that is being
offered in Indian medical colleges and institutions. This means that they were satisfied with
them when they graduated with their degrees and feel that it is proper.

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It is well recognized that assuring a minimal level of health care to the population is a critical
constituent of the development process. The expansion of medical education in the country
has been rapid since independence, but it continues to remain inadequate by the standards of
developed countries. This is reflected in the shortage of health professionals and health
services by international benchmarks, and wide disparities remain between rural and urban
areas and also between the various states. The need to expand India’s medical education and
research system is therefore urgent, and the pressing challenge is to achieve this while
maintaining world-class quality.

3. Rate the overall efficiency and effectiveness of our health care

system.

 Analysis:
1 doctor responded with a rating of 5.
2 doctors responded with a rating of 6.
6 doctors responded with a rating of 7.
4 doctors responded with a rating of 8.
2 doctors responded with a rating of 9.

1) Dr. Amitabh Kenny

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

2) Dr. Swapnil Kenny

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

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 3) Dr. Vipul Manek
The expert rated a 9 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is almost perfect. There are little deficiencies and hardly any further
work to be done to make the system better.

4) Dr. Brijesh Manek

The expert rated an 8 meaning that the expert thinks the overall efficiency and effectiveness
of our health care system is very good. There are just some deficiencies and just some further
work to be done to make the system better.

5) Dr. Mukesh dhadhich

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

6) Dr Parul Nema
The expert rated a 6 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is just average. There is significant further work to be done to make
the system better.

7) Dr Shubhum Choudhary
The expert rated a 9 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is almost perfect. There are little deficiencies and hardly any further
work to be done to make the system better.

8) Dr. Uttam Choudhary

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

9) Dr. Madhavi chordia

The expert rated a 5 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is just average. There is significant further work to be done to make
the system better.

10) Dr. Manu Maheshwari

The expert rated an 8 meaning that the expert thinks the overall efficiency and effectiveness
of our health care system is very good. There are just some deficiencies and just some further
work to be done to make the system better.

11) Dr. Sapna Kini

The expert rated a 6 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is just average. There is significant further work to be done to make
the system better.

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 12) Dr Anand Nagori
The expert rated an 8 meaning that the expert thinks the overall efficiency and effectiveness
of our health care system is very good. There are just some deficiencies and just some further
work to be done to make the system better.

13) Dr. Mahima hasija

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

14) Dr. Nitin Mulgaonkar

The expert rated an 8 meaning that the expert thinks the overall efficiency and effectiveness
of our health care system is very good. There are just some deficiencies and just some further
work to be done to make the system better.

15) Dr. Bhavna Mulgaonkar

The expert rated a 7 meaning that the expert thinks the overall efficiency and effectiveness of
our health care system is above average. There is further work to be done to make the system
better.

 Interpretation:
This suggests that majority of the doctors rated above 7 which shows that doctors think the
overall efficiency and effectiveness of the healthcare system is good.
Huge investments have been made in improving the health system of India since early
independence, which has resulted in health outcomes such as infant and maternal maternity
rates and life expectancy levels to exhibit impressive reductions and increments, respectively.

4. Is the medical workforce sufficiently diversified based on

specialization?

P a g e 49 | 75
  Analysis:
9 doctors think that the medical workforce is sufficiently diversified based on specialization.
3 doctors were doubtful whether the medical workforce is sufficiently diversified based on
specialization.
3 doctors think that the medical workforce is not sufficiently diversified based on
specialization.

1) Dr. Amitabh Kenny

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

2) Dr. Swapnil Kenny

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

3) Dr. Vipul Manek

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

4) Dr. Brijesh Manek

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

5) Dr. Mukesh dhadhich

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

6) Dr Parul Nema
The expert has replied with a “no”. This says that the expert does not think that the current
Indian medical workforce is sufficiently diversified based on specialization.

7) Dr Shubhum Choudhary
The expert has replied with a “maybe”. This says that the expert is doubtful whether the
current Indian medical workforce is sufficiently diversified based on specialization.

8) Dr. Uttam Choudhary

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

9) Dr. Madhavi chordia

The expert has replied with a “no”. This says that the expert does not think that the current
Indian medical workforce is sufficiently diversified based on specialization.

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 10) Dr. Manu Maheshwari
The expert has replied with a “no”. This says that the expert does not think that the current
Indian medical workforce is sufficiently diversified based on specialization.

11) Dr. Sapna Kini

The expert has replied with a “maybe”. This says that the expert is doubtful whether the
current Indian medical workforce is sufficiently diversified based on specialization.

12) Dr Anand Nagori

The expert has replied with a “maybe”. This says that the expert is doubtful whether the
current Indian medical workforce is sufficiently diversified based on specialization.

13) Dr. Mahima hasija

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

14) Dr. Nitin Mulgaonkar

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

15) Dr. Bhavna Mulgaonkar

The expert replied with a “yes” which says that the expert thinks that the current Indian
medical workforce is sufficiently diversified based on specialization.

 Interpretation:
Majority of the doctors do think that the medical workforce is sufficiently diversified based
on specialization. Some are doubtful and some do not agree with the same.
Multi specialization could help the Indian sector in sufficiently diversifying the health
workforce. The concept of multi-specialization is original because it tries to reconcile, as a
precise model, the specialization level of a person with his/her deepest professional goals. In
other words, it tries to accomplish both the satisfaction of the employers’ and the
community's needs for qualified workers to fill available jobs with the freedom of each
individual to learn and pursue self-chosen goals and at the same time contribute to a
universally better social outcome. The classical approach would defend full specialization
regardless of the individuals’ learning aspirations and the new work and social realities
people experience today.

P a g e 51 | 75
 5. Does our Healthcare system have adequate infrastructure to meet the
needs of doctors?

 Analysis:
10 doctors think that healthcare system does not have adequate infrastructure to meet that
needs of the doctors.
3 doctors were doubtful whether healthcare system does have adequate infrastructure to meet
that needs of the doctors.
2 doctors think that healthcare system does have adequate infrastructure to meet that needs of
the doctors.

1) Dr. Amitabh Kenny

The expert answered “Yes” to this question which says that the expert thinks that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is no need
for any further investment into medical infrastructure.

2) Dr. Swapnil Kenny

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

3) Dr. Vipul Manek

The expert has replied with a “maybe” which implies that the expert is doubtful on the
answer to the question whether our Healthcare system have adequate infrastructure to meet
the needs of doctors.

4) Dr. Brijesh Manek

The expert has replied with a “maybe” which implies that the expert is doubtful on the
answer to the question whether our Healthcare system have adequate infrastructure to meet
the needs of doctors.

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 5) Dr. Mukesh dhadhich
The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

6) Dr Parul Nema
The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

7) Dr Shubhum Choudhary
The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

8) Dr. Uttam Choudhary

The expert answered “Yes” to this question which says that the expert thinks that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is no need
for any further investment into medical infrastructure.

9) Dr. Madhavi chordia

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

10) Dr. Manu Maheshwari

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

11) Dr. Sapna Kini

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

12) Dr Anand Nagori

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

13) Dr. Mahima hasija

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

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 14) Dr. Nitin Mulgaonkar
The expert has replied with a “maybe” which implies that the expert is doubtful on the
answer to the question whether our Healthcare system have adequate infrastructure to meet
the needs of doctors.

15) Dr. Bhavna Mulgaonkar

The expert has replied with a “no”. This says that the expert does not think that our
Healthcare system have adequate infrastructure to meet the needs of doctors. There is a need
for investment in the medical infrastructure.

 Interpretation:
Majority doctors think that healthcare system does not have adequate infrastructure to meet
that needs of the doctors. There is a clear need for the same.
Most of the problems that Indian healthcare is facing currently is primarily due to low
government spending on healthcare. Public health facilities comprise of 20% of the Indian
primary healthcare system. Majority of the secondary and tertiary care centres come under
the private sector. A typical govt. hospital doesn’t have sufficient doctors, nurses or staff.
Such hospitals are often crowded because they are catering to a large population in the
surrounding area. They do not have enough beds (because they’ve excess patients). They’re
dirty and unhygienic, they lack security, patient care is unheard of, there may often be
shortage of medicines and consumables, staff may be corrupt and seek bribes from patients,
they may even lack basic utilities like steady supply of water, electricity and fuel. Their
ambulances may be unavailable due to breakdown or corruption, forcing patients to fend for
themselves.

6. Is our healthcare system sufficiently funded?

 Analysis:
11 doctors think that the healthcare system is not sufficiently funded.
2 doctors are doubtful whether the healthcare system is sufficiently funded.

P a g e 54 | 75
2 doctors think that the healthcare system is sufficiently funded.

1) Dr. Amitabh Kenny

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

2) Dr. Swapnil Kenny

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

3) Dr. Vipul Manek

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

4) Dr. Brijesh Manek

The expert has answered with a “maybe” to this question. This implies that the expert is
doubtful whether our healthcare system is sufficiently funded.

5) Dr. Mukesh dhadhich

The expert has answered with a “yes” to this question. This implies that the expert thinks our
healthcare system is sufficiently funded. There is no need for more funds allocation into the
healthcare system.

6) Dr Parul Nema
The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

7) Dr Shubhum Choudhary
The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

8) Dr. Uttam Choudhary

The expert has answered with a “maybe” to this question. This implies that the expert is
doubtful whether our healthcare system is sufficiently funded.

9) Dr. Madhavi chordia

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

P a g e 55 | 75
 10) Dr. Manu Maheshwari
The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

11) Dr. Sapna Kini

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

12) Dr Anand Nagori

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

13) Dr. Mahima hasija

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

14) Dr. Nitin Mulgaonkar

The expert has answered with a “yes” to this question. This implies that the expert thinks our
healthcare system is sufficiently funded. There is no need for more funds allocation into the
healthcare system.

15) Dr. Bhavna Mulgaonkar

The expert has answered with a “no” to this question. This implies that the expert does not
think our healthcare system is sufficiently funded. There is a dire need for more funds
allocation into the healthcare system.

 Interpretation:
This can also be easily proved by secondary data that the healthcare system of India is not
sufficiently funded. The doctors also responded with the same thing.
Higher spending will enable public hospitals to acquire medicines and supplies, receive
uninterrupted water and electricity supply, maintain the premises and keep it clean and safe,
maintain equipment and ambulances so that they’re functional and available when required.
More funding on medical and nursing colleges and technical training centers would help
increase the existing number of seats or open new colleges in more locations. This would
produce more number of skilled medical manpower to cater to the huge demands of our
population. With more funding and easy availability of skilled manpower, more public health
facilities can be opened so that individual centers are not overcrowded. When the number of
patients is manageable, they can be provided beds, medicines and proper care. With more
funding, the government can provide free treatment to the poor through the public health

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system. In addition to free treatment, the government can provide health insurance to the poor
so that they can avail treatment in private hospitals as well.

7. Rate the overall effectiveness of Insurance Agencies.

 Analysis:
1 doctor has rated 5.
4 doctors have rated 6.
3 doctors have rated 7.
6 doctors have rated 8.
1 doctor has rated 9.

1) Dr. Amitabh Kenny

The expert has rated 6 indicating that the expert feels the overall effectiveness of medical
insurance agencies is just average. There is a lot of scope for improvisation in this sector.

2) Dr. Swapnil Kenny

The expert has rated 6 indicating that the expert feels the overall effectiveness of medical
insurance agencies is just average. There is a lot of scope for improvisation in this sector.

3) Dr. Vipul Manek

The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

4) Dr. Brijesh Manek

The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

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 5) Dr. Mukesh dhadhich
The expert has rated 7 indicating that the expert feels the overall effectiveness of medical
insurance agencies is above average. There some scope for improvisation in this sector.

6) Dr Parul Nema
The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

7) Dr Shubhum Choudhary
The expert has rated a 9. This implies that the expert is highly positive about the overall
effectiveness of Insurance Agencies and does feel it is almost perfect.

8) Dr. Uttam Choudhary

The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

9) Dr. Madhavi chordia

The expert has rated 5 indicating that the expert feels the overall effectiveness of medical
insurance agencies is just average. There is a lot of scope for improvisation in this sector.

10) Dr. Manu Maheshwari

The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

11) Dr. Sapna Kini

The expert has rated an 8. This implies that the expert is positive about the overall
effectiveness of Insurance Agencies and does feel it is really good with just a bit of
deficiencies.

12) Dr Anand Nagori

The expert has rated 7 indicating that the expert feels the overall effectiveness of medical
insurance agencies is above average. There some scope for improvisation in this sector.

13) Dr. Mahima hasija

The expert has rated 6 indicating that the expert feels the overall effectiveness of medical
insurance agencies is just average. There is a lot of scope for improvisation in this sector.

14) Dr. Nitin Mulgaonkar

The expert has rated 6 indicating that the expert feels the overall effectiveness of medical
insurance agencies is just average. There is a lot of scope for improvisation in this sector.

15) Dr. Bhavna Mulgaonkar

The expert has rated 7 indicating that the expert feels the overall effectiveness of medical
insurance agencies is above average. There some scope for improvisation in this sector.

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  Interpretation:
This question received a bit of mixed answers from the experts. Although, a clear indication
can be perceived that all doctors think that Insurance agencies are above average.
Expansion of health insurance / assurance coverage is a necessary step, and a pathway in
India’s effort to achieve Universal Health Coverage (UHC). Low Government expenditure on
health has constrained the capacity and quality of healthcare services in the public sector. It
diverts majority of individuals – about two-thirds – to seek treatment in the costlier private
sector. However, low financial protection leads to high out-of-pocket expenditure (OOPE).
India’s population is vulnerable to catastrophic spending, and impoverishment from
expensive trips to hospitals and other health facilities.

8. How well did Indian Healthcare handle the Covid situation?

 Analysis:
6 doctors rated 7.
2 doctors rated 8.
6 doctors rated 9.
1 doctor rated 10.

1) Dr. Amitabh Kenny

The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

2) Dr. Swapnil Kenny

The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

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 3) Dr. Vipul Manek
The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

4) Dr. Brijesh Manek

The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

5) Dr. Mukesh dhadhich

The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

6) Dr Parul Nema
The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

7) Dr Shubhum Choudhary
The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

8) Dr. Uttam Choudhary

The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

9) Dr. Madhavi chordia

The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

10) Dr. Manu Maheshwari

The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

11) Dr. Sapna Kini

The expert has rated an above average rating of 7. A rating of 7 indicates that the expert
thinks the covid situation could have been handled a lot better than it was actually handled.

12) Dr Anand Nagori

The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

13) Dr. Mahima hasija

The expert has rated 8 meaning the expert thinks that the covid situation was handled pretty
well with a bit of misconduct.

14) Dr. Nitin Mulgaonkar

The expert answered with a rating of 9 which indicates that the covid situation was handled
almost perfectly with very little misconduct.

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 15) Dr. Bhavna Mulgaonkar
The expert has rated 8 meaning the expert thinks that the covid situation was handled pretty
well with a bit of misconduct.

 Interpretation:
The doctors were highly positive that India did well during the pandemic situation. None of
the doctors have rated below 7.
In the beginning, coronavirus cases in India happened due to the abroad connection rather
than transmission within the country. Initially, it was considered that India was dealing well
with a low number of positive cases from COVID-19 because of the constricted transmission
during a lockdown and social distancing. The Indian government (central and state level) is
working intensely to minimalize the number of cases and consequences daily and is taking all
necessary steps to combat the challenges and threat posed by this growing invisible pandemic
war involving public, medical association, nurses, NGOs, police forces, including
paramilitary. Earnest efforts of all the frontline workers especially medical doctors, nurses,
healthcare staff, sanitation workers, police personnel, volunteers, and active support and
obedience of people of India has been the only possible reason owing to the control and
treatment of pandemic. Additionally, to treat/stop this COVID-19 infection there is a pressing
need to handle this battle at a scientifically advanced level. Indian government got critically
involved with the COVID-19 outbreak and started scanning every person. Currently, the
testing facility includes Real-time PCR test, Point-of-Care molecular diagnostic assays, rapid
antibody test (suitable for surveillance as the results come after 7–10 days of the pandemic
infection) and point of care rapid antigen detection test for early detection of COVID-19.

9. Do you think India will be able to handle another pandemic-like

situation?

 Analysis:
6 doctors think that India will be able to handle another pandemic-like situation.

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5 doctors are doubtful whether India will be able to handle another pandemic-like situation.
4 doctors think that India will not be able to handle another pandemic-like situation.

1) Dr. Amitabh Kenny

The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

2) Dr. Swapnil Kenny

The expert replied negatively when asked whether India will be able to handle another
pandemic like situation. It is safe to say that the expert believes that the current healthcare
system is not capable of handling another pandemic.

3) Dr. Vipul Manek

The expert was doubtful whether India will handle another pandemic like situation. This tells
us that the expert does not trust the current operations of our healthcare system.

4) Dr. Brijesh Manek

The expert replied negatively when asked whether India will be able to handle another
pandemic like situation. It is safe to say that the expert believes that the current healthcare
system is not capable of handling another pandemic.

5) Dr. Mukesh dhadhich

The expert replied negatively when asked whether India will be able to handle another
pandemic like situation. It is safe to say that the expert believes that the current healthcare
system is not capable of handling another pandemic.

6) Dr Parul Nema
The expert was doubtful whether India will handle another pandemic like situation. This tells
us that the expert does not trust the current operations of our healthcare system.

7) Dr Shubhum Choudhary
The expert was doubtful whether India will handle another pandemic like situation. This tells
us that the expert does not trust the current operations of our healthcare system.

8) Dr. Uttam Choudhary

The expert was doubtful whether India will handle another pandemic like situation. This tells
us that the expert does not trust the current operations of our healthcare system.

9) Dr. Madhavi chordia

The expert was doubtful whether India will handle another pandemic like situation. This tells
us that the expert does not trust the current operations of our healthcare system.

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 10) Dr. Manu Maheshwari
The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

11) Dr. Sapna Kini

The expert replied negatively when asked whether India will be able to handle another
pandemic like situation. It is safe to say that the expert believes that the current healthcare
system is not capable of handling another pandemic.

12) Dr Anand Nagori

The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

13) Dr. Mahima hasija

The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

14) Dr. Nitin Mulgaonkar

The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

15) Dr. Bhavna Mulgaonkar

The expert has a positive outlook when asked whether India will be able to handle another
pandemic like situation. This shows that the expert believes in the current infrastructure and
workforce.

 Interpretation:
The answer to this question was completely mixed. The question itself was a bit subjective
and vague as it was not clear what assumptions were taken. That might have caused the
doctors to give a mixed reply.
COVID-19 has emerged as a public health threat around the world. It adds to the list of
previous epidemic infectious disease outbreaks, including Bovine Spongiform Encephalitis in
1986, the Avian flu in 1997, the SARS in 2002, the Swine Flu in 2009, and the Ebola in
2014. All these outbreaks remind us that we live in a habitat where it is necessary to respect
the relationship between animal, social life, and the environment to survive and thrive. Rapid
urbanization and our incursion into forest lands, has created a new interface between humans
and wildlife; and exposed humans to unfamiliar organisms often involving the consumption
of exotic wildlife.

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 [Link] what extent do you think poverty affects the health care system in
India?

 Analysis:
1 doctor rated 5.
1 doctor rated 6.
6 doctors rated 7.
3 doctors rated 8.
2 doctors rated 9.
2 doctors rated 10.

1) Dr. Amitabh Kenny

Since the expert has given a rating of 9, the expert thinks that poverty plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

2) Dr. Swapnil Kenny

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

3) Dr. Vipul Manek

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

4) Dr. Brijesh Manek

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

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 5) Dr. Mukesh dhadhich
The expert has given a rating of 8 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

6) Dr Parul Nema
The expert has given a rating of 8 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

7) Dr Shubhum Choudhary
Since the expert has given a rating of 9, the expert thinks that poverty plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

8) Dr. Uttam Choudhary

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

9) Dr. Madhavi chordia

The expert has rated an average score of 5 which says that poverty does affect the health care
system in India, but not so much.

10) Dr. Manu Maheshwari

Since the expert has given a rating of 10, the expert thinks that poverty plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

11) Dr. Sapna Kini

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

12) Dr Anand Nagori

Since the expert has given a rating of 9, the expert thinks that poverty plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

13) Dr. Mahima hasija

The expert has given a rating of 8 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

14) Dr. Nitin Mulgaonkar

The expert has given a rating of 7 indicating that the expert believes poverty does play a
significant role in affecting the health care system in India.

15) Dr. Bhavna Mulgaonkar

The expert has rated an average score of 6 which says that poverty does affect the health care
system in India, but not so much.

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  Interpretation:
With these responses, we can conclude that all doctors do believe that poverty does play a
role in affecting the health care system of India.
India’s health system faces the ongoing challenge of responding to the needs of the most
disadvantaged members of Indian society. Despite progress in improving access to health
care, inequalities by socioeconomic status, geography and gender continue to persist. This is
compounded by high out-of-pocket expenditures, with the rising financial burden of health
care falling overwhelming on private households, which account for more than three-quarter
of health spending in India. Health expenditures are responsible for more than half of Indian
households falling into poverty; the impact of this has been increasing pushing around 39
million Indians into poverty each year.

[Link] what extent do you think illiteracy affects the health care system
in India?

 Analysis:
3 doctors rated 6.
2 doctors rated 7.
2 doctors rated 8.
5 doctors rated 9.
3 doctors rated 10.

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 1) Dr. Amitabh Kenny
The expert has rated an average score of 6 which says that illiteracy does affect the health
care system in India, but not so much.

2) Dr. Swapnil Kenny

The expert has given a rating of 7 indicating that the expert believes illiteracy does play a
significant role in affecting the health care system in India.

3) Dr. Vipul Manek

Since the expert has given a rating of 9, the expert thinks that illiteracy plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

4) Dr. Brijesh Manek

The expert has given a rating of 8 indicating that the expert believes illiteracy does play a
significant role in affecting the health care system in India.

5) Dr. Mukesh dhadhich

Since the expert has given a rating of 9, the expert thinks that illiteracy plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

6) Dr Parul Nema
Since the expert has given a rating of 9, the expert thinks that illiteracy plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

7) Dr Shubhum Choudhary
Since the expert has given a rating of 9, the expert thinks that illiteracy plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

8) Dr. Uttam Choudhary

The expert has given a rating of 8 indicating that the expert believes illiteracy does play a
significant role in affecting the health care system in India.

9) Dr. Madhavi chordia

Since the expert has given a rating of 10, the expert thinks that illiteracy plays one of the
major roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

10) Dr. Manu Maheshwari

Since the expert has given a rating of 10, the expert thinks that illiteracy plays one of the
major roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

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 11) Dr. Sapna Kini
The expert has given a rating of 7 indicating that the expert believes illiteracy does play a
significant role in affecting the health care system in India.

12) Dr Anand Nagori

Since the expert has given a rating of 10, the expert thinks that illiteracy plays one of the
major roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

13) Dr. Mahima hasija

Since the expert has given a rating of 9, the expert thinks that illiteracy plays one of the major
roles in affecting the healthcare system of India and solving it should be one of the top
priorities to ease the pressure on the healthcare system.

14) Dr. Nitin Mulgaonkar

The expert has rated an average score of 6 which says that illiteracy does affect the health
care system in India, but not so much.

15) Dr. Bhavna Mulgaonkar

The expert has rated an average score of 6 which says that illiteracy does affect the health
care system in India, but not so much.

 Interpretation:
The rating given by the doctors says that they do believe that illiteracy plays a role in
affecting the healthcare of India. Since all the doctors have given a rating of above 5, we
can clearly say that illiteracy does affect our healthcare system. Low health literacy is
associated with failure to seek timely medical help, lower rate of vaccination in children,
increased burden of sexually transmitted diseases in the youth, the inability to interpret
and follow up with prescribed medication for the elderly, and consequently higher
morbidity. The school and college curriculum must include ‘body literacy’ from the
primary classes onwards to sow the seeds of health literacy in the young minds, so that
they grow into healthy adults. A health-literate India would be a richer and more
productive country. If we want to become a developed country, this is one of the first
hurdles we need to cross.

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 [Link] system will improve to the required standards in the
future years.

 Analysis:
2 doctors strongly agreed.
8 doctors agreed.
4 doctors replied with a neutral opinion.
1 doctor disagreed with the statement.

1) Dr. Amitabh Kenny

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

2) Dr. Swapnil Kenny

The expert chose the “strongly agree” option stating that the expert completely believes in the
future of the Indian healthcare system and it will be strong enough up to the required
standards to sustain by itself.

3) Dr. Vipul Manek

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

4) Dr. Brijesh Manek

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

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 5) Dr. Mukesh dhadhich
The expert chose the “strongly agree” option stating that the expert completely believes in the
future of the Indian healthcare system and it will be strong enough up to the required
standards to sustain by itself.

6) Dr Parul Nema
The expert chose the “neutral” option which says that the expert is doubtful whether the
Healthcare system will improve to the required standards in the future years.

7) Dr Shubhum Choudhary
The expert chose the “neutral” option which says that the expert is doubtful whether the
Healthcare system will improve to the required standards in the future years.

8) Dr. Uttam Choudhary

The expert chose the “neutral” option which says that the expert is doubtful whether the
Healthcare system will improve to the required standards in the future years.

9) Dr. Madhavi chordia

This is the only expert having chosen the “disagree” option indicating the expert does not
trust the future of the Indian healthcare system.

10) Dr. Manu Maheshwari

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

11) Dr. Sapna Kini

The expert chose the “neutral” option which says that the expert is doubtful whether the
Healthcare system will improve to the required standards in the future years.

12) Dr Anand Nagori

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

13) Dr. Mahima hasija

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

14) Dr. Nitin Mulgaonkar

The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

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 15) Dr. Bhavna Mulgaonkar
The expert has picked the option “agree” indicating that the expert does believe that the
Healthcare system will improve to the required standards in the future years. The expert thus
has a positive outlook.

 Interpretation:
This question tested whether the experts believe that the future of healthcare system of India
will improve or not. According to the response received, doctors do believe that Healthcare
system will improve to the required standards in the future years.
In a nutshell, the healthcare sector witnessed an increased public spend on health and well-
being. However, addressing the persistent manpower and skill gap and measures to improve
private sector participation will bode well for an overall improvement in healthcare delivery
as well as education facilities. Success would now lie in how these new initiatives are
implemented. It will be important to shift the focus towards the quality of implementation of
the new programmes and schemes as well as on fostering convergence across health
programmes. It might also lead to creation of a robust, collaborative ecosystem for the public
and private healthcare providers to work together in quest of desirable outcomes.

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 Conclusion
1. India being a developing country, its healthcare sector is also at a growing stage.
Indian Healthcare System has a long way to grow to reach the top-quality healthcare
systems. Looking at the universities offering best quality education and government
constantly trying to improve the existing infrastructure, India does have the potential
to develop its healthcare to the best standards.
Spain being a developed country, has one of the world’s best healthcare systems. It
has one of the world’s healthiest people with an average life expectancy of 81. Yet, it
does have a few things it has to work on. No healthcare system can be perfect.

2. India provides free healthcare to all its residents as well as any foreign national. It is
able to do this even after being the world’s 2nd largest in terms of population.
Spain also has universal healthcare free of cost but only to its residents or any
individual who is from the European union. Thus, foreign nationals do have to pay for
healthcare in Spain to avail those services.

3. Private healthcare consumption consists around 15 to 18% of the total hospital

services provided in India. The main reason behind this is the low quality of services
provided in public hospitals. That’s why the Indian public would rather pay more and
get treated at a private hospital.
Only 8-10% of Spaniards get themselves treated at private healthcare. This shows the
efficiency and effectiveness of the public healthcare system. The only drawback here
is long waiting times in public hospitals.

4. There is a common conception among Indians that doctors are not qualified enough
and they misuse their position by delaying the treatment in order to charge more fees
from the patients. This can be confirmed by the question asked in the survey. Thus, a
majority of Indians do not trust doctors and think that they just loot them.
The case is a lot different among Spaniards. According to the secondary data
collected, Spaniards are satisfied with the treatment they get offered. This might be
because more than 90% get treated at public hospitals and the doctors get paid only
from the government, thus there’s no use in delaying the process.

5. The pandemic situation was not handled well by India. Even after lockdowns, cases
kept rising resulting in lack of hospital beds for patients and even lack of oxygen
cylinders. India has survived all the pandemic waves, but it could have been managed
even better.
Spain’s healthcare system was much efficient in handling the pandemic but it had an
aging population problem. This is the reason why the deaths due to covid in Spain
were so high.

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 Recommendations:
 India

1. India continues to spend some of the lowest amounts as a country on health, around
1.1% of its GDP. Budget allocation, especially after the pandemic hit should be
increased to around 6% of the GDP. This will ensure the latest infrastructure is used
by all public hospitals and the general public will start trusting public facilities.

2. The system of Health planning and decision making has been highly centralized and
top-down with minimal accountability, little decentralized planning or scope for
genuine community initiatives; the failure of most State supported community health
worker schemes being one of the most striking consequences of this. Thus, there is a
dire need for decentralization of hospitals. This will ensure that all hospitals will
quote what infrastructure and budget they need according to their local requirements
rather than someone from the top authority deciding for every hospital.

3. There is also a major problem of misutilization of funds. Even though on paper the
funds have been allocated to the hospitals, how much has been actually reached? How
much has been actually utilized in providing services and infrastructure? Black money
is a challenge faced by India since a long time. There must be steps taken to mitigate
this issue.

4. There must be a focus on medical colleges and institutions and it must be ensured that
students are being provided the top-quality education according to the latest standards.
There should be no compromisation on this aspect as these are the students who are
going to handle the lives of thousands of people throughout their lives.

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 Spain

1. With a decrease of birth rates, and an ageing population, the need for long-term care
of chronic diseases will increase in the coming years. Spain lacks adequate facilities
and coordination of home-care services for patients requiring long-term care. In
addition, hospital data shows that a very low number of deaths occur in hospitals,
which indicates a tendency to transfer terminal patients to their homes. It is
recommended that Spain should focus on this particular problem.
2. There is a general consensus among Spaniards that they have suffered with long wait
times in public hospitals. This is due to a higher doctor to patient ratio and thus can be
solved by hiring new doctors of the specialization which are in need.
3. All healthcare is free in Spain except for dental care. The government should try to
include dental care also into the universal public healthcare system. This move will
develop satisfaction among the general public that their tax money is being utilized
efficiently.
4. In conclusion, in Spain there is a general consensus that health care is a right and not a
privilege, and all political parties have come to agree. There is no such thing as a
perfect health care system, and each country has to continuously adapt to the needs
and economic constraints of its changing population. The Spanish case proves,
however, that even with limited resources it is possible to provide universal access to
adequate health care to improve the health of the population.

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 Bibliography:
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