” COVID-19 – Superpower’s Flutter of Confusion ” – June 8, 2020.

          Frequent cinegoers will remember the film, “The Titanic” ,  released 23 years ago (December 19,  1997).  The movie added fictional elements to historical elements. The luxury steamship will start sinking after striking an iceberg off the coast of Newfoundland. Those occupying the lower decks in the ship will be prevented from coming out by closure of the doors. Those in the upper decks will also be prevented but not until they escape and take refuge in small boats out of the ship. Even with the danger threatening the lives of everyone aboard the ship, discrimination will neither wither nor be lessened.  On the contrary, it will spell an elevation of the strength and capacity of such actions can be gleaned from those scenes of the film.

          On March 29, 2020, when US President, Donald Trump, announced that the corona deaths will cross the figure of 1 lakh in America, the entire world stood shocked, stunned and confused. That it can happen in America, the World’s  Superpower and the richest nation was the shocking factor.

          America is the aim and esteemed destination of lakhs of young Indians. About 2 lakh students go to America every year for pursuing higher studies. About 4 thousand students wait for visas before the American Consulate buildings every day in India.

          About 14 lakh Indians went to America and returned last year as tourists. Celebrities in the fields of politics, business, theater, and sports travelling to America for better  ‘medical treatment’  is not uncommon. A country renowned for its technology, innovation, higher education, medical facilities, business prowesss, and research is struggling now to contain the death rattle due to COVID-19.

          OECD countries usually earmark 8% of its GDP for healthcare. US  allocation is double that amount – 16% of its GDP. It is equivalent to $ 3 Trillion annually (Rs. 300 lakh crores). Each individual spends $ 11000 (approx. Rs. 830000/-) every year for healthcare. Significant to note is the fact that the Indian average is  Rs. 1625/-.

          It is mandatory that every citizen in America be enrolled in  at least one Comprehensive Health Insurance Scheme for availing treatment. Fine for not being in one health insurance scheme at least was removed only in 2017. All health schemes provide for access to American citizen’s basic healthcare requirements. Even if someone is not in the health insurance scheme, he/she will be permitted access to emergency healthcare at all times. Poor people cannot afford the expenses normally, otherwise.

          About 56% participate in schemes of employee organisations ;  22% enroll in Medicaid ;  8% receive independent health insurance benefits ;  4%  receive benefits from Medicare ;  and  10% constitute those on the poverty line who have been left behind in health insurance.

          Senior Citizens, 65 or above, covered by Medicare has been funded by the Federal government. For the benefit of those living below the poverty line and for the alternately abled individuals,  ‘Medicaid’  is the final destination. For this, funding comes from both Central and State Governments.

          Medical expenses are generally high in America. In particular, costs of higher level medical treatments and drugs are quite high. Medical expenses are usually divided into segments and a portion of the expenses in segments can be separately insured. However, the patient has to meet the general expenses. Hence, when the proportion of the patient’s  share is high, cost of medical treatment will also rise significantly.

           Not all treatments are covered by Health Insurance. According to the eligibility requirements of a particular Insurance Scheme, individuals will receive healthcare. Leading hospitals with technologically superior and greater modern facilities (equipment plus infrastructure) exist in America. Indian celebrities choose such medical facilities generally for treatment. They put themselves akin to the rich/ultra rich in America.

          Even while being the richest nation, America does not provide equal facility/convenience for all its people. Health Insurance and the accompanying infrastructure takes the burden of Health Department budget. There is the general perception that the present structure and procedures of the scheme seriously regards with disfavour the Latin Americans, Blacks, and Hispanic people.

          Even individuals filing bankruptcy unable to meet the medical expenses is common in America now. Losing their belongings ; and pledging the house or other immovable property as collateral for equivalent medical care are some of the pitiless incidents observed. About 30000 people die due to lack of medical care every year, statistics reveal.  Apart from the 10% people being unable to join the Health Insurance Scheme, there is now the danger of more people losing healthcare after COVID-19. Every individual losing the job also loses health insurance.

          About 3 crore individuals not finding themselves in any health insurance scheme face different situations in their lives. It is a critical moment in the country’s history now. The authorities are in dialogue with private medical facilities to meet the urgent needs of people in view of the danger escalating amidst COVID-19.

          America is the most powerful nation in the world ;  America spends trillions of dollars to control COVID-19 ;  and yet, we see the highest number of deaths there is what raises serious questions against the Health Department. It is common to witness debates, analysis and discussion on the status of Healthcare during the election period. However, monetarily powerful private medical groups and units have protected their interests, supporting the basic healthcare schemes they desire, is the opinion held, it appears.

          Financial assistance for various government schemes come normally from the general budget. However, the administration and procedural implementation of the health schemes still seem to favour private facilities. The present COVID-19 crisis and events are the most glaring example of the problem. This has resulted in close scrutiny of the divisions of the Health Department now.

          Though America, viewed as a model for various activities in most sectors and followed by many nations of the world, the present crisis and its fabric there is not an example to follow is becoming evident now. It strikes straight on our face the difficulties and challenges in assigning control of some key public safety activities to private organisations. Significant to note is the fact that our government’s fair dinkum treatment is appropriate and accepted.

          At least 100 years have passed since the Titanic disaster. Unless and until newfangled tech innovations, research, higher education, and applications reach every section of society, no economic development can appeal to all classes of society.

   “Dieu avec nous”

   Monday, June 8, 2020 – 11.19 a.m. (IST)

   Tidbit :  ” Art of medicine consists of amusing the patient while nature cures the disease “.