Nepal has made some commendable improvements in the field of health over the last decade. Average fertility rate per women has gone down from 3.1 in 2006 to 2.6; under-five mortality has declined to 54 deaths per 1,000 live births from 61 deaths per 1,000 in 2006; the under-five underweight percentage, likewise, has dropped to 29 percent from 39 percent in 2006. But while these achievements sound impressive, the country still has a long way to go to meet the needs of as much as 50 percent of its populace that is still deprived of even basic healthcare facilities.
The biggest barrier to easy access to healthcare services for the poor has been prohibitively high cost of medical services. In this situation, the announcement of Human Organ Transplant Center (kidney hospital) in Bhaktapur to provide dialysis and kidney transplant services at minimal costs has come as a relief for hundreds of poor Nepalis. According to the center, it will avail dialysis services for as little as Rs 250, when the same charge at private hospitals runs from Rs 3,000-Rs 6,000. Likewise, someone needing a kidney transplant will now be able to make it for around Rs 100,000, again many times cheaper compared to the rates offered by private hospitals. The poor renal patients not able to access similar affordable services at Bir Hospital will now have another option and hence another shot at life.
Any such initiative which could potentially save hundreds of lives every year needs to be promoted and supported. But the fact remains that the Bhaktapur center will be able to operate only around 40 hemodialysis machines within the next few years, still leaving countless patients needing similar services in a lurch. Surely, given the will, the country’s private healthcare centers could provide comparable cost-effective services.
The fact that private hospitals are charging as much as 20 times the rate of Bhaktapur center seems grossly unfair, especially for poor patients. Of course, this should be the case not just in treatment of renal patients, but in the whole range of services they offer. But recent record suggests that private healthcare institutions are willfully neglecting their public duty. For instance, even the most reputed private hospitals in Kathmandu have failed to renew their licenses, which is vital to ensure that they are providing quality services. Considering the high rates they are charging their patients, such neglect cannot be justified.
Nor can they wash their hands off their duty to take care of the increasing number of patients suffering from all kinds of debilitative diseases around the country. For it has become amply clear that underfunded and under-resourced government healthcare providers will not be able to meet the growing demand for affordable healthcare services. We thus believe private healthcare providers can (and should) play a more constructive role in improving the overall efficiency and cost-effectiveness of the country’s healthcare sector. In a poor country like Nepal private hospitals that cater exclusively to the rich clientele, we are afraid, are willfully turning a blind eye to the plight of poor and the middleclass patients who often have to pay with their lives for their inability to marshal enough resources