CFHI’s Global Heatlh Immersion Program has given me the chance to pick out the differences between our two healthcare systems and discern for myself what works and what doesn’t in each system. Though the two systems are vastly different, there are a few similarities and things that work for both and don’t work for either.
The first difference that I noticed is that of insurance, or lack of medical insurance in India! Most healthcare is provided on a pay out of pocket basis, or based on free government subsidized healthcare that I described in postings below. There are two types of hospitals and clinics: private and government. If a patient is attending a private clinic they are required to pay 100% out of pocket up front and each clinic charges differently depending on specialty, etc. On the other hand, if a patient is being seen at a government hospital, payment widely varies.
We have been told that India is seeing an increase in insured patients but doctors preferred uninsured patients because they can make more money off of them. Insurance companies are still paying the prices of five years ago for procedures and office visits even though the cost has gone up. In a lot of the clinics and hospitals we observed at, doctors talked about this fact and how many auto rickshaw drivers make more money than they do simply based on this fact.
Another great difference between India and the US is how many patients a doctor sees in an hour or day. Here in India, it wasn’t uncommon for a doctor to see sixty patients in three hours and then close their doors for the rest of the day (some of them going to the operation theater). If you do the math on how long they spend with each patient it is very minimal compared to that of the US. Sometimes, a doctor here won’t even do a physical exam and prescribe drugs or procedures based solely on the history!
The use of diagnostic testing in India is almost always unheard of. Even when I was sick, the only test they ever ran was blood levels to see what my white count was and if I had any elevated or depressed immune cells. Not once did they ever try to find out what microorganism (probably enteric) was actually causing my symptoms which was incredibly frustrating to me as the woman who was on the first month of my program was diagnosed with typhoid fever upon arrival in the United States.
It has been said that we rely too much on this diagnostic testing in the US but I feel as though there is a happy medium that neither country has reached. India could use a bit more testing to confirm or even make their diagnoses and America could use a bit less testing and more doctors’ instinct and history to make their decision.
There are a lot of aspects about health care and the global health field that I have learned through CFHI’s global immersion programs. It has been an eye-opening experience and I truly think that anyone discerning a career in the health field should take advantage of this amazing opportunity!