Intended for healthcare professionals

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What counts?

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39476.584005.47 (Published 31 January 2008) Cite this as: BMJ 2008;336:0

Rapid Response:

Health Consumerism Vs Medical Consumerism

Dear Tony,
Good issue with excellent articles and your comments are superb! I wonder
if India would be able to benefit from the Netherlands experience to get
every pregnant woman to deliver in the hospital.

I couldn't agree more with Des Spence's condemnation of the
privatization of medical care in the developing countries. It has become
truly "consumerism hell." Recent studies have shown that the poor man's
greatest debt burden, resulting in a spate of suicides by farmers in some
parts of India, is from the huge hospital bills!

I have deliberately removed the word "health" from Spence's phrase to
emphasize the need to make it clear that doctors and hospitals have very
little to do with society's health. The latter depends on clean drinking
water, housing, good food, sanitary facilities, economic empowerment of
the masses and education. This might not impress people in the UK but one
will understand that in the context of the so called third world.

Only 0.2% poor people use Government hospitals in many northern
States in India while the most advanced State of Kerala only 2.8% use the
government facilities! Our spending on private care is a whopping 78% and
our spending on public care is very, very low. This is the best industry
now and every corporate house is eyeing hospital "business" as the best.

Bernard Mandeville described corporate business is that which exists
for profit only; philanthropy has no place there. One could only shudder
to think of the day when corporate hospitals will be looking for more
illnesses in society for them to get better profits. Isn't this worse than
"medical consumerism hell"?

Yours ever, bmhegde
Competing interests: None declared

Competing interests:
None declared

Competing interests: No competing interests

02 February 2008
BM Hegde
Editor in Chief, Journal of the Science of Healing Outcomes
Mangalore 575 004