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Corruption in the Medical sector.
#1
A recent news report covered the story of the involvement, of medical professionals in India, in receiving favours in the form of "incentives to doctors" from hospitals for referring patients to them.

TOI report

To my knowledge it is much deeper involving "medical representatives", who represent big companies. Many years back I heard from an honest pharmacist how medicine manufacturing companies paid bribes to government ministers to have their new products authorized for marketing. He also told me that a medicine I bought for Rs 1/- was probably just 1/10 the cost; the price being inflated by the pharma company with the nod being given by the govt. officials in return for "benefits".

A doctor's fee is usually pretty high for the average Indian. Some doctors do not even offer a receipt for the consultation fee. It is pocketed away with a reminder to revisit after a certain period of time for a follow-up consultation.

Here are the original articles which resulted in the News report.

Corruption ruins the doctor-patient relationship in India - David Berger
http://www.bmj.com/content/348/bmj.g3169

Quote:Although the causes and effects of corruption are complex, a few strands can be teased out. The healthcare system itself is a model of inequity; it is one of the most privatised in the world, with out of pocket expenditure on healthcare at more than 70%, far higher even than in the United States.

Quote:There is also widespread corruption in the pharmaceutical industry, with doctors bribed to prescribe particular drugs. Tales are common of hospital directors being given top of the range cars and other inducements when their hospitals sign contracts to prescribe particular antibiotics preferentially.

The following is a follow-up article to the one above.
The private health sector in India - Amit Sengupta, Samirun Nundy
http://www.bmj.com/content/331/7526/1157
Quote:The recent remarkable growth of the private health sector in India has come at a time when public spending on health care at 0.9% of gross domestic product (GDP) is among the lowest in the world and ahead of only five countries—Burundi, Myanmar, Pakistan, Sudan, and Cambodia. This proportion has fallen from an already low 1.3% of GDP in 1991 when the neoliberal economic reforms began.

I do hope more money is budgeted for public health care and related areas in the future.

On a lighter note some of these problems turn into comedy tracks in movies.
There is one where a patient walks into a hospital with a scratch on his knee or something. The nurse orders an X-ray, blood test, urine test, CAT scan etc etc. The patient swoons.
Progress might have been all right once, but it has gone on too long -- Ogden Nash
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#2
A follow up...

Two American studies have yet again highlighted the growing malaise of unnecessary medical investigations. US journal, Arthritis and Rheumatology, has found that about a third of the total knee replacements (TKR) in US might have been unnecessary. Since processes are more lax in India, the problem could be bigger here.

In addition to doubts over the need of all knee replacements, US-based National Cancer Institute has questioned the efficacy of digital mammography over conventional mammography in detecting breast cancer. Digital mammography is much more expensive than the conventional one.

These findings by reputed institutes and journals have added to the raging controversy about unnecessary medical investigations and procedures. An article based on a 270,000-patient study published in the Journal of the National Cancer Institute found that though the use of digital mammography increased significantly between 2001-02 and 2008-09, contributing to a 31% increase in screening-related costs for women in the medicare programme, it did not translate into increased breast cancer detection rates.

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Progress might have been all right once, but it has gone on too long -- Ogden Nash
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