"Overtreatment and Overmedication in India's Health System"
Polypharmacy
a single patient being prescribed five or more medicines at the same time
Deprescribing
the planned reduction or stopping of medicines no longer needed or appropriate
India's healthcare system has two opposite problems. Some patients get tests, procedures and medicines they do not need. This is called overtreatment. At the same time, many others, especially poor people, cannot get even basic primary care. This contradiction comes from how Indian healthcare is organised. Health is placed under the State List in the Seventh Schedule. This means states have the main responsibility for organising health services. The Union government's role is mostly limited to national schemes and narrow price-control tools. This same decentralisation explains why India has long favoured curative care over prevention. The public system has historically focused on treating sickness rather than preventing it. Partly, this is because preventive and promotive health work needs sustained local administration. This administration varies sharply across states.
A large private healthcare sector has grown into this gap. It now handles most secondary and tertiary care. Government health spending has stayed well below the target set by the National Health Policy, 2017. That policy aimed for 2.5% of GDP. Actual spending has remained closer to 1.4%. With public investment low, private hospitals, diagnostic chains and pharmaceutical companies have grown into a competitive marketplace. This marketplace rewards volume: more tests, more scans, more prescriptions. Over time, this has created conditions where medical decisions are shaped as much by commercial incentives as by clinical need.
The Ayushman Bharat Digital Mission creates a unified digital health records system. It improves interoperability and data sharing across health providers. Adoption of the Digital Mission by private hospitals is voluntary, not mandatory. Public hospitals are encouraged to participate.
Overtreatment is rarely a single bad decision. It usually begins as a chain. A screening test finds a minor abnormality. This abnormality is often harmless. This leads to a follow-up test, then a diagnosis. Finally comes a prescription or procedure that may continue for years. A review in a leading Indian medical journal found that routine health check-up packages often include tests not backed by evidence. These tests produce false alarms, anxiety and unnecessary further treatment.
A second driver is the fragmentation of care around specialists. Patients with everyday health problems often go directly to a specialist. They do not see a general physician first. Patients with multiple conditions may see several specialists. Each specialist treats one organ system without seeing the whole person. …
Consider the following statements:
Statement-I: India's public sector health care system largely focuses on curative care with limited preventive, promotive and rehabilitative care.
Statement-II: Under India's decentralized approach to health care delivery, the States are primarily responsible for organizing health services.
Which one of the following is correct in respect of the above statements?
In a crucial domain like the public healthcare system the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.
With reference to India's health governance, consider the following statements:
1.'Health' is placed in the State List under the Seventh Schedule to the Constitution.
2.States are primarily responsible for organising health services under India's decentralised health delivery system.
3.The Union government has no statutory mechanism to regulate medicine prices anywhere in India.
Which of the statements given above is/are correct?
Consider the following statements regarding the global 'Choosing Wisely' movement:
1.It originated as a response to overtreatment concerns first recognised in high-income countries.
2.Between 2012 and 2023, specialty medical societies worldwide published recommendations on tests and treatments to be questioned.
3.The movement is legally binding on all member countries' health ministries.
How many of the above statements are correct?
Match the following drivers of overtreatment with their correct description:
List I (Driver) — List II (Description)
A.Defensive medicine — 1. Payment structure rewarding volume of services over outcomes
B.Fee-for-service model — 2. Ordering extra tests mainly to avoid missing a rare diagnosis
C.Fragmentation of care — 3. Multiple specialists treating one patient without coordinated oversight
D.Moral hazard — 4. Altered treatment choices because a third party bears the cost
'Polypharmacy', as used in the context of healthcare for older adults, refers to which of the following?
Want the full note, Prelims Facts & MCQ answers?
Create a free account — takes less than a minute.
Create free account