High Private Healthcare Costs and Role of Govt.

If hospital bills Rs 100, direct plus indirect cost of providing healthcare service is Rs 75 to 90. Every one talks about Rs 100 charged to patient. Nothing is done to reduce / subsidize Rs 75 to 90 expenses. Electricity bill, water bill, medical equipment, taxes , real estate building cost etc etc- nothing is subsidized and charged at actual.

There are some 200+ laws which hospitals have to follow. If govt is serious about affordable healthcare, it should ensure that hospitals survive. Govt itself is not spending and day by day making it difficult for hospitals to survive through these laws and bills like KPMEA.

Govt taxes all vendors supplying services and goods to hospitals. These vendors include those taxes/ gst in their bills. These taxes/ gst are indirectly paid by hospital. All salaries to doctors and employees, govt taxes it in the form of income tax. This income tax/ tds is deducted and paid by hospital. After paying to doctors ( income tax) , employees ( income tax), housekeeping vendor (gst), security vendor ( gst), Maintainance vendor (gst), electricity bill, water bill, bmw bill (gst), medical equipments (gst), AMC/ CMC ( gst), drugs and consumables (gst), EMI of loans, canteen bill ( gst) etc etc whatever profit remains govt taxes it at 25 to 35 % as Corporate tax. In this entire value chain, govt earns more than individual doctor, individual employee,individual vendor and hospital.

Govt must either invest in healthcare infrastructure or at least reduce the above mentioned tax burden and laws so that hospitals can survive and provide affordable healthcare.

Private healthcare contributes to 75% of healthcare services provided in India. Private healthcare is delivering excellent high quality patient clinical outcomes thanks to our talented doctors and advanced medical equipments.

Private healthcare is providing high quality healthcare services at 1/10th cost when compared to developed world countries.

Government spends less than 1.5% gdp on healthcare which is extremely low. Government hospitals could provide services at lesser price because their cost of running hospital is financed from tax payer’s money. I heard that Govt spends 100 to 200 cr + for running one tertiary care hospital. If this amount is to be charged to patients, prices at Government hospital will also rise. Resident doctors are exploited at a very low salary / stipend in government hospitals. Doctor to patient ratio and nurse to patient ratio is grossly inadequate in many government hospitals.

People are taking health for granted and not able to understand that high costs are involved in receiving medical treatment. Private Healthcare insurance penetration is less than 5%. Many a times insurance coverage amount is very less. We are ready to buy car insurance at 10k but not our body ( health) insurance at similar range price per annum. The way car insurance is compulsory for every car, we should make health insurance compulsory for every person. We need to create more awareness in society.

Regards,
Dr Sameer Kulkarni

https://www.linkedin.com/pulse/high-private-healthcare-costs-role-govt-dr-sameer-kulkarni/?trackingId=BUIS6Q8VS9gWQ9xiUwaDgw%3D%3D

Nice sentence read today

Everything is easy if you are crazy about it & Anything is difficult if you are lazy about it.

God

God is an entity where you deposit your positivity, energy, faith, inner strength. Whenever you feel low, you go back to this entity to withdraw some of the positivity and energy to fight against difficult circumstances. It is like a bank. Many people deposit their inner strength at this entity. Not everyone is capable enough to believe in thy self and store all this energy which can do anything if used appropriately. So they store this energy in God. When saints say God and I God are the same they mean to say that it is my inner strength and potential which manifests in God. God is nothing but my positive emotions and strength stored in an entity. Everything is within me. Since I doubt myself, I cannot believe that I can do anything. So I store this inner potential in God. I believe that God can do anything. 

Since it is very tough to believe in thy self, we create God and put trust and faith in him. Plus there is a factor of luck which is not in our hands so we pray or hope that things will be alright with God’s grace.

In reality finally everything boils down to how much you try and do. You need to believe in yourself – inner potential or God (your inner potential stored in external entity) and try your best. Rest is luck and destiny.

Tony Robbins:

Decision -> standards -> belief -> massive action


What you focus on, you find that. If you focus on people not caring about you, you being unlucky, you will find many events and reasons to find that it is true. If you focus on being lovable and lucky, you will find many events and reasons to find that it is true. What you focus on , you find and get it. Most of the times we focus on such things subconsciously or unconsciously. We need to change that and consciously focus on things we want to focus on.Second is decision and choices.We always have a choice and make decision.

1) We always have a choice - whether to just survive or to live life. Once we choose to live, we can start enjoying and appreciating the delicacies of life.

2) Once a choice is made, second step is decision. We need to decide what will we change or do to live life fully.

3) Once decision is made, we need to raise our standards and not compromise on that. You need to believe in the decision to maintain and continue with standards. You need to expand or change the limiting beliefs. If you decide to become millionaire but you have a belief that it is not possible then you won't be able to maintain the standards.

4) Next step is implementation and action. 

If there is no visible change in action then it means decision is not powerful.


Positive thinking does not help. Positive massive action does.

Education and schooling asks us to be disciplined and be silent , don't talk etc. That makes us passive. Business requires opposite characters - pro activeness, go getter, disruptive innovation, talkative and communicative.

Commit yourself to outstanding standard better than excellence not good or poor or average at all.

Exercise muscle and it will develop. Exercise confidence, standard, attitude and it will develop. Exercise 'feel good'. Emotion starts with motion. You can make yourself feel good and you have to do that. It changes everything.

Conditioning - driving - on phone -take direction which might be opposite because of conditioning. Similarly condition yourself for being positive, happy, confident, peak state, feel good.

Feeling is governed with
1) Physiology and motion,
2) Language and self dialogue,
3) Your focus and belief system.

What stops you from getting what you want - fear. successful people have stress not fear.

Question you ask yourself is very important. If you ask negative question, you will get negative answers. If you ask why I am not good, you will get many answers. If you ask how you can make yourself better, whole focus changes. To change focus ask different questions.

Clarity is most powerful weapon. If you are clear about your goal, your brain helps you get there. Clarity will need purpose. why question helps you get clarity. Purpose drives.

Perception - whatever you perceive is going to be true. Perception can make you feel euphoric or depressive about the same thing.

Physiology - Physiology can change perception.

Strategy 

Right Posture
Right Internal Dialogue
Right Dress & Presentation
Compliment and boost other's confidence
Fake it till you make it.
I like myself feeling is very important for self esteem. Feelings govern actions. You can control feelings by changing the focus.

All actions are governed by decision.
Decision - positive , enthusiasm, energetic , successful - quality of person you want to be - this then governs actions. live life at highest levels. Circumstances and conditions do not decide your destiny. Decisions decide destiny.
Decision is different from wishlist and preferences. Decision is no option.

Decisions - actions - analysis - correction to achieve - result. Don't focus on process , be flexible and focus on result. Decision -> result. Don't focus on decision - process - result. be flexible with process not result.

Pain and pleasure influence your behavior, decision and action. Pain and pleasure is driven mostly by perceptions. If you are not taking action then you are associating more pain than pleasure for it. Change the perception to pleasure over and over to govern actions. Change the false neuro association connections of pain in the past.

Belief governs decisions, actions, body. Belief is most powerful. Change bad belief - 1) use pain pleasure association 2) create doubt - ask questions. If you question anything many times, doubt arises.Use it for bad belief and avoid them for good belief. Good belief if used becomes conviction. Take action - it is feeder to belief.  

Change happens in an instance. Change needs support of pain - pleasure association support. First believe that change can happen. We are responsible for change not some one else. Dis-empowering beliefs hinder decisions. Change is must and urgent.  

Goals are always there. many times they might not be conscious goals. But i do not have goals is not true. Ur subconscious goals might be pay bill, feel good, earn money. Goals - disappointments in past make you not set your real goals. Believe and create compelling future and goals. Have goals for different areas of life. Have absolute faith in goals. 

Pain pleasure principle is linked with action - inaction. Actions lead sometimes to criticism, failure or rejection. It results in pain. Our mind associates actions with pain. It prefers inaction over action. We need to train our mind that inaction leading to no result is more painful than action leading to rejection, criticism and failure. Action is life and we are born to live life, take actions. Without actions there is no meaning to life and existence. Fear of criticism, failure or rejection should not govern your actions and life. Meditation helps in dealing with criticism, failure or rejection. It connects you with your true self and God. You start taking action without fear and enjoy the gift called life.


Belief becomes reality . Belief affects thinking.Thinking affects feelings. Feelings affect physiology - body and posture. Thinking, feeling and physiology affect action. Actions affects success and reality. Belief gets its required support from thinking, feeling, physiology, action to affect success and reality

Belief is something which our subconscious mind trusts in. Belief can be modified. Doubt bad beliefs. Reinforce good beliefs.

Faith is something which our conscious mind trusts in. 

Criticism : No matter what you do people are going to judge you, evaluate you and criticize you. They will have positive opinion, negative opinion or neutral opinion based on their perception, experiences and preconceptions. Criticism comes from jealousy or ignorance. In no case criticism should stop or affect you from being you. Because no matter what you do there will be criticism and evaluation. Best practice is to be true to yourself. 

Negative words - Hope try but should would could

Positive words - Do, make, and, will, now, can /can't, choose,  want
absolutely, definitely, certainly, obviously, naturally, sure, of course, no doubt

Do it now.  Next 24 hrs will not come back. Invest properly.  They are very precious

Each Day is a new Life for a wise Man !!!

Success can not be a goal but a Byproduct

Thought a lot on what is success. Many a times it is a state of mind. If you think of moments when you felt successful in the past life, you see that many a times it is an accomplishment which is recognized by society or people around you. Some times it is just something that is very valuable to you nothing related to people. But many a times societial recognition, people perceptions define success. People who are rich are considered successful in general. But are they really successful? They might be successful in the mind of society and people, but what about their own perception of success. Do they feel successful?

If success is a perception and state of mind, we need to define what is success for us. No matter what we achieve or what we earn there will be people who are better than us in that. You earn 1 crore and there are people who earn 10 crore.  Also there are people who earn 10k and feel that they are very successful. In short we set expectations for ourselves, keep on comparing / benchmarking expectations w r t peers, other people and define a state/ condition where we will feel successful. As we keep on accomplishing, we redefine and elevate the standards of conditions defining success for us. If we fail to achieve the set standards, we feel that we are not yet successful or unsuccessful. These set standards are highly influenced by peers, society and people. This is where problem comes. We start doing things for people. Thats what Steve Jobs explains in his keynote at Stanford.

Is success important? If yes then why? Success makes you feel good about yourself. Society recognizes you, respects you. This respect makes you feel better and cycle goes on. To achieve this cycle lot of efforts are poured in by us. Some efforts which we love to put in and some efforts we hate to put in. After that if we achieve success ( defined condition), we feel good. Otherwise it makes us feel sad.  

After much thought I feel that you should not care about success as long as you are happy about current state and are enjoying life. You should keep on doing good things and things which you truly enjoy doing. As long as you are enjoying and happy about yourself, why to care if you are successful or not. Success can not be a goal but a byproduct. If we keep doing good things with enjoyment, sooner or later we will get fruits - which will give us recognition in the eyes of society and make us successful from peoples' point of view. During whole process we are happy about ourselves as we are doing things we like. Even if we do not succeed or succeed late, it is ok because we are happy about ourselves. Instead of defining a state of success and chasing it , it is better to keep on doing good things which we enjoy and be successful.

There is no point in taking life too seriously and chasing success. On daily basis doing enjoyable good work is very important. Enjoyment and happiness is the goal, success follows in. We generally take it other way round.    

It is very easy to loose hope in this country. It is very easy to set your aspirations low in this country. - Narayan Murthy, Infosys.