Many in small towns fall prey to the seemingly grand picture painted by such cronie arrangements in the city and try to play into their game.

The previous five articles exposed the present structure of corporate health care managers who using the favourable conditions of cheap labour.

Many doctors go on a spree of profit venture of sub letting the brands to a chain of cronies who can ensure the economic interests of the top with the help of unnecessary staff (for hospitals)  like business development managers and call centers etc.

Many in small towns fall prey to the seemingly grand picture painted by such cronie arrangements in the city and try to play into their game, played by such health care brands as INDIRA IVF, and utterly fail.

While analysing such failures to run a health care set up, one has this baffling fundamental question in mind as to why should a health care set up fail to run in the first place, when there is so much demand for it.

Believing in the fact that there is deficiency of services left over due to government withdrawal seems not to be working.

To expound the reason and the dynamics behind the non viability of smaller non corporate clinics, we need to look at the whole ecosystem of the health care industry. This consequence for small clinics and hospitals is true even if it is invested in a far away towns and clinics.

The ecosystem allows such profitability and viability on the one hand for the corporate health care clinics even in the light of non essential paraphernalia which they carry, like the advertising, marketing and call center staff.

But one of the crucial factors apart from unquestioning doctors, relaxed labor laws, collusion of political class and bureaucracy, ill equipped medical colleges and anti-people laws is the pharmaceutical industry and the medical gadget industry which unflinchingly favours the corporate health sector.

It is well known that an author had already exposed the Generic Pharma industry of India with her book titled “bottle of lies”.

He has clearly mentioned how the industry had intentionally reduced the quality of manufacture process to increase profitability, at the cost of health of the public, who are at the mercy of government regulators like the Drug Control General of India (DCGI) for ensuring quality control of the drugs in the market.

The DCGI who just like other government agencies may be under the command of the political class for whatever needs or deficiencies they harbour.

It is of importance here to know that a drug company called INTAS (for example) provides a drug to Indira IVF at a price which is almost one fourth of the price for the same medicine available in the open market, or half the price they can give to other clinics or doctors.

Even if we presume that they are collaborating for a common cause (only with Indira IVF) and hence reducing the price in view of a bulky order placed by Indira IVF for the drug in question, the question strikes the mind that if that can be viable why not make the drug available in open market also at the same price so that the same cause of helping the patient can be achieved?

The preferential secretive collusion between such drug companies (like INTAS) and hospitals like Indira IVF may be serving other sinister purposes.

Apart from compromising on the drug quality and safety standards (a natural suspicion due to lowered cost only for a selected hospital) and by reducing the price for select hospitals only, the sinister advantage is that of not allowing those other clinics from small towns and who also want to play the same profit game as the corporate health care as Indira IVF should not survive.

So when small hospitals from small towns ask for the same drug to be delivered at same cost as that given to Indira IVF, it is not given to them for some strange reason unknown to most in the supply chain of INTAS.

Hence making it a clear message to small hospitals in small towns and other clinics even in the same town, that it may not be viable to play the same game as Indira IVF and also a message to fall in line to the economic demand of sending off patients to such hospitals in cities instead of treating them in their towns and villages.

It is a well known fact about the pharma industry in the country, which is exemplified by the cronyism brought to light in the case of Ranbaxy, which gave a considerable blow to the credibility of drug manufacturing in the country at international level, government is often hard pressed to regulate such cronies who in the name of family business, just like Indira IVF is a family business, cause sufficient harm before its known to the country.

The only people who benefited were the family and the babas (possibly politicians) who support them.

Knowing well that these secretive collusion between pharma companies and corporate health care companies make it unviable for other smaller clinics to run even if they run in nearby towns because the aggressive marketing spree by the corporates with the promise of lower prices make the patients flock to such hospitals.

The consequence being the investment in health in the remote places become lesser and lesser and the cities are over loaded with for-profit corporate brands which find more and more collusive ways to monopolize and then go for the kill by increasing the prices. On cost escalation the insurance companies also collude and finally we see the exclusively -elite- class- serving hospitals in the cities.

In the smaller towns and villages the already decrepit public health care which is now not attracting any private investment has to just refer the patients over for everything including cardiac emergencies, and hence even the locally placed health care workers flock to the city to work there, who are welcome in cities like any other migrant labour because they agree for lesser salaries, and hence more profits for the cronies again.

The government on one side makes it compulsory for rural service after graduation and post graduation from medical colleges and on the other hand makes it unviable for health care to be run in the towns and villages and makes it profitable for the corporates to thrive by supporting them in more than one way.

The pharma people like the INTAS are definitely making the citizens of the remote places in this country risk their lives and come to cities for treatment instead of allowing its medicines to be allowed at more or less same cost all across in the country (if not less for the poor in the villages and towns).

The medical gadgets are made very sparsely in this country and most are imported, and the high cost of the same makes it another impediment to invest in the remote places like towns and villages because it doesn’t fetch as much returns in the villages.

Hence lower standard of care is imminent in such places, this becomes all the more a valid reason for people to access corporate hospitals rather than other hospitals.

The overall consequence being deterioration of the public health model and propagation of for- select- few (profit and treatment) kind of model, the results are clear when we look at similar models in other countries, for example USA which boasts of its animal spirits for profit on the Wall Street (and now very high number of deaths in pandemic) and it also looks down upon the public health models like that of Cuba.

It is left to us whether we want a public health model which is not for profit, which can save us during an epidemic because of possibility of robust infrastructure even in remote towns and villages or for-select-few profit oriented corporate who with selective nexuses with Pharma companies like INTAS make it a possibility to have Holocaust like picture all around.

Welcome to the for profit pandemic of the pharma industry of India.

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