KATHMANDU, APRIL 22
Dr Neil Pande, a Kathmandu-based dental surgeon with nearly three decades of clinical experience and an early adopter of digital dentistry, believes that healthcare in Nepal is often discussed in terms of cost. Patients believe it is pricey. Doctors feel underpaid. The system, somewhere in the middle, struggles to achieve balance. "However, if we look closely, the issue does not start at the clinic. It starts much earlier."
According to him, one of the primary causes of rising healthcare costs is the cost of inputs. Medical supplies, implants, and even medications are frequently more expensive in Nepal than in neighbouring India.
"This is due to policy, not quality differences. Previously, Nepal could import third-country products through India, taking advantage of India's large market volume and competitive prices. When this pathway was halted, procurement costs quietly rose. Direct imports, smaller volumes, and fewer suppliers resulted in higher prices from the start. If we want affordable healthcare, we must reconsider," he adds.
"Simultaneously, system professionals face pressure. Healthcare professionals face double taxation, which adds to their financial burden. Consultation fees, on the other hand, have remained nearly constant for years, even as the cost of living has risen dramatically. This imbalance fosters an unhealthy environment in which financial survival can start to influence clinical decisions."
He emphasised that if Nepal truly wants ethical, patient-centred care, we must provide better support to our doctors. Countries such as Malaysia have demonstrated how this can be done.
"They provided young doctors with financial stability early in their careers by subsidising medical education, securing government employment, and providing access to low-interest housing and vehicle loans. This allowed them to concentrate on patient care rather than the constant financial stress," he says.
"Nepal can adapt similar principles to its own context. Offering low-cost loans for housing, vehicles, and setting up practice can go a long way in supporting new graduates. Also, creating more job opportunities within the government sector is essential."
Another important step forward as per Dr Pande is the creation of a national health records system. A central, digital repository of patient data can improve continuity of care, reduce duplication, and support better decision-making. The architecture for such a system is no longer a distant idea. It is practical, achievable, and necessary."