Structures
India has a universal, decentralized health care system managed by both the Central and state government. The central Government oversees medical education and collects statistics on infectious diseases. The US does not have a universal health care system yet though efforts are on.
Infrastructures
In India Hospitals and Clinics are managed by Government and private bodies. 75% of the hospitals and clinics are run by the respective state governments providing primary, secondary and tertiary health care. In the US, health care is almost totally in the private sector, provided to employees by their employers. Government only provides for those who are unemployed and incapable of purchasing medical insurance.
Budget
The Indian Government allocates only 4 to 5 % of its GDP for health care which amounts to some $40 per person annually. This is much less than what the Governments of Sri Lanka and Bangladesh allocate. The US spends almost 16% of its GDP on health care which is above world standards.
Costs
At the Government run hospitals and clinics, the patient has to pay nominal and subsidized fees while at the private ones he pays 100 % of the cost. For the average Indian citizen almost 70% health care expenses are paid for from his or her pocket. In the case of the US citizen it only amounts to only 10 to 12 %.
Insurance
Medical insurance covers only a very minor percentage of the Indian population. There is very little awareness in India among the general public about it or its benefits. The amount paid by available insurance policies are outdated and do not reflect the current cost of health care. Hence most Indian doctors prefer uninsured patients. In the US medical insurance is an important base of its health care system.
Water & Sanitation
Very little attention is paid in Indian Health Care system towards the provision of safe water and sanitation. The quality of piped water is very poor. Similarly very few public toilet exists. Only some 25 % of the population has access to sanitation, forcing majority of the people to go for open defecation. Even where public toilets are available they are always in dirty and broken down condition. This is not so in the US.
Examination
Indian Doctors devote far little “examination time” on each patient, seeing some 60 patients in three hours. Sometimes drugs are prescribed without physical examination. Besides Diagnostic testing is hardly used in India. This is also true for private doctors. This is not so in the US where doctors spend more time on each patient and it is said that diagnostic testing is the norm. However it is much easier and faster to get an appointment with a doctor in India than in the US. Patients who had experiences in both system mention that Indian Doctors treat patients as humans while with US doctors a patient is more like an object.
PATIENT CARE
The staffs in Indian hospitals are very rude and rough in their behavior towards patients. In US hospitals, the staffs particularly the nurses are very caring and polite.
Cleanliness
Government run Indian hospitals and clinics are very poorly maintained. Rubbish heaps is a common sight around hospitals. Toilets and Bathrooms are often very dirty and unwashed. In contrast US hospital and clinics are 1000 times cleaner.
Efficiency
In terms of “Life expectancy at Birth “while in India it is 63/66 in the US it is 76/81. Similarly the “ Probability of dying “ for children under five in India is 65 in 1000 while for the US it is 8 per 1000 live births.
Medicines
In India one can easily get medicines over the counter even without a doctor’s prescription. Sometimes one can relate to the pharmacist ones problem and will be provided with a medicine. In the US this would not be possible.
Conclusion
In comparing the two health care systems, it is obvious that India has much to learn and adopt from the US.