COVID-19 Poll: 67.5% of Indians expressed worry about not being able to afford testing or treatment for Coronavirus

The Team CVoter Corona Tracker Economy Battery (Wave 3) survey conducted from 18th to 23rd May 2020 asked respondents about their view of the effect of the Coronavirus crisis and lockdown on their economic condition. The survey included questions on respondents’ viewpoint on the implementation of the lockdown, the relief package announced by the government as well as fear of not being able to afford medical care, food and job loss.

Overall, around 67.5% of respondents expressed worry about not being able to afford testing or treatment for Coronavirus if needed. In today’s infographic, Team Polstrat breaks down which demographic groups express the most worry about not being able to afford treatment.

Almost half of the respondents are “very worried” about not being able to afford testing or treatment for the Coronavirus. For a nation of 1.35 billion people, this translates to roughly around 63 crore people being very worried about being able to afford treatment and an additional 28 crore people being “somewhat worried” about the same. At the same time, 26.2% of respondents stated that they were not worried at all about not being able to afford testing and treatment.

Who is most worried about not being able to afford testing and treatment for Coronavirus?

There is a stark difference between those in higher and lower-income and education groups and their worry about being able to afford treatment and testing for Coronavirus. 72.2% of respondents in lower education groups and 78.3% of those in lower-income groups are worried about not being able to afford testing and treatment. This figure is almost flipped when we look at the higher income group, with only 27.3% of respondents stating they are worried about not being able to afford testing and treatment.

Treatment and testing for Coronavirus in all government hospitals in India is free of cost. In April, the government as a part of the Ayushman Bharat scheme announced free testing and treatment of COVID-19 in eligible hospitals. As per NSS data from 2017–18, 85% of Indians living in rural India and 81% of Indians living in urban India were not covered by any insurance scheme. While Ayushman Bharat has increased coverage, it is important to remember that this is a means-tested scheme. Families that earn more than Rs 10,000 a month or own a refrigerator, or a two-wheeler, amongst other amenities, can not benefit from the scheme.

Additionally, the costs of testing and treatment for Coronavirus at private hospitals are paramount. Testing in private laboratories is only free for those covered under Ayushman Bharat or belonging to economically weaker sections of the society as notified by the government. The Indian Council for Medical Research has set an upper limit for prices for Coronavirus testing in private hospitals at Rs. 4,500.

Estimated costs of treatment at a private hospital are even more significant. While the cost of treatment will depend on a range of factors, including age, the load of the virus, other related ailments, without any life-saving equipment, is estimated to be around Rs. 20–25,000 daily. This would mean the average 14-day treatment without any ventilator support would cost around Rs. 2,80,000 to Rs. 3,50,000. Additionally, patients can only be discharged after multiple (3–5 minimum) negative tests, all of which adds to the cost of treatment. If the patient is older or is suffering from an extreme load of the virus, he or she could require ventilator support which is an additional Rs. 25,000 a day (estimated). Given these estimates, treatment at a private hospital would be unaffordable for the average Indian.

Urban-Rural Healthcare Divide in India

Overall, respondents in rural India are much more worried (71%) than in urban areas (59.6%) about being able to afford Coronavirus treatment and testing. Testing and treatment are free in all government and Ayushman Bharat empanelled hospitals, but access to healthcare is much harder in rural areas.

In order to understand the difference between access to healthcare and medical facilities in rural India, one has to understand the tiered system of healthcare in both rural and semi-urban areas. In rural areas, Indians have access to a tiered healthcare system with Service Centres (SC) at the bottom-most level (first point of contact), followed by Primary Healthcare Centres (PHC), Community Health Centers (CHC) and finally District Hospitals (DH). For most people living in rural areas, their first point of contact with a medical/clinical personnel is through an Auxiliary Nurse Midwives (ANMs) in Service Centres.

However, this is where the shortfalls of the healthcare system prevent access to adequate healthcare. In poorer states such as UP and Bihar, roughly 10% of Service Centres do not even have ANMs. People often have to travel anywhere from 10km to over 100km to find the nearest medical facility and there is an acute shortage of ambulances in such areas. This disparity becomes acutely heightened during the lockdown, whereby, there is no access to public transport.

Additionally, when it comes to PHCs around 8% do not have clinical staff, 39% do not have lab technicians and 18% of them do not even have a pharmacist. Several state and district hospitals do not have adequate ICU beds, specialists or other clearances. While the government is attempting to create more isolation wards by introducing trains furnished with hospital beds and converting medical colleges and schools into treatment facilities, the reality is that the penetration of the healthcare system, even with the availability of free treatment is very low. Due to the infrastructural limitations of the healthcare system, those living in remote rural areas can not access any form of medical services.

From Polstrat, a non-partisan political consultancy which aims to shift the narrative of political discourse in the country from a problem-centric to a solutions-oriented approach. The question had a “Don’t Know/Can’t Say” option which was selected by 1.6% of respondents.All survey findings and projections are based on the Team CVoter Corona Tracker Economic Battery Wave 3 survey carried out in May 2020 among 18+ adults statewide, including every major demographic. (Sample Size: 1474) Team CVoter (Center For Voting Opinions and Trends in Election Research) is a leading international stakeholder research organization with its roots in India.

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