Vaidya saadhana: Healthcare economics through ages - From cost crisis to zero-cost diabetes care
Year: 2025
Type: article
Abstract: Healthcare costs have been rising steadily worldwide, creating significant challenges for both healthcare systems and individuals. According to the World Health Organization (WHO), global expenditure on health has increased dramatically over the past two decades, with a particularly concerning impact on Low and Middle-Income Countries (LMICs). In LMICs, the burden of increasing healthcare costs is especially severe due to limited public health infrastructure, inadequate insurance coverage, and high out-of-pocket expenditure. The WHO reports that approximately 100 million people are pushed to extreme poverty annually due to healthcare expenses.[1] In these countries, households often face catastrophic health expenditure, defined as spending more than 10% of their total income on health care.[2] India, as a prominent LMIC, faces significant challenges in affordable health care. Nearly 7% of Indians fall into poverty every year due to healthcare costs.[3] The country’s healthcare system is characterized by high out-of-pocket expenditure, limited insurance coverage, increasing costs of medical technology and pharmaceuticals, and a growing burden of chronic diseases. Interestingly, ancient Indian medical texts provide a unique perspective on healthcare accessibility. The Ashtanga hridaya, specifically Chapter 12 (Prameha chikitsa), presents a comprehensive, cost-free treatment protocol for patients with Prameha (~diabetes mellitus).[4] …………….…छत्रपादत्ररहितो मुनिवर्तनः ॥ योजनानां शतं यायात्खनेद्वा सलिलाशयान् । गोशकृन्मूत्रवृत्तिर्वा गोभिरेव सह भ्रमेत् ॥ A patient with diabetes, should incorporate regular physical exercise into their treatment regimen, may particularly benefit from walking regularly, starting with modest distances approximately 800–900 miles (100 Yojanas) without the comfort of an umbrella or footwear, embracing a disciplined and austere lifestyle, as physical activity remains a cornerstone of diabetes management. In addition, the patient should embrace a disciplined lifestyle with appropriate dietary modifications suitable to their circumstances. Alternatively, they could dig their own water reservoir or live among cows, dealing with cow dung, urine, and other related challenges. The treatment module is summarized in Table 1.Table 1: Treatment summaryThe WHO recommends several strategies that align remarkably with ancient wisdom explained in the context of Ashtanga hridaya-Pramaeha chikitsa mentioned in Table 2 as validation of ancient and modern aspects.Table 2: Validation of ancient and modern aspectsFUTURE IMPLICATIONS AND INTEGRATION The synthesis of Ashtanga hridaya’s wisdom with modern healthcare approaches represents a transformative opportunity in addressing the current healthcare cost crisis. When ancient medical knowledge is thoughtfully integrated with contemporary healthcare practices, it creates a robust framework for sustainable healthcare delivery. The development of cost-effective treatment protocols becomes possible by incorporating time-tested lifestyle modifications alongside modern medical interventions. For instance, the Ashtanga hridaya’s emphasis on physical activity through walking long distances can be adapted into structured exercise programs that require minimal resources yet yield significant health benefits. This integration naturally leads to a greater emphasis on lifestyle interventions, where traditional practices like regulated Dinacharya (~daily regimen) complement modern behavioral therapy approaches. The increased focus on preventive care emerges organically from this synthesis, as ancient wisdom primarily emphasized maintaining health rather than merely treating disease – a principle now validated by modern public health research. Furthermore, this integrated approach particularly benefits LMICs by offering accessible healthcare solutions that do not rely heavily on expensive infrastructure or pharmaceuticals. The juxtaposition of ancient wisdom and modern healthcare challenges reveals that effective health care need not always be expensive. The Ashtanga hridaya’s approach to diabetes management demonstrates how lifestyle-based, zero-cost interventions can complement modern medical practices. As healthcare systems worldwide grapple with rising costs, these ancient principles could influence modern healthcare policy and practice, potentially offering sustainable solutions to the global healthcare affordability crisis. This philosophy finds remarkable resonance with John Ruskin’s seminal work “Unto This Last,” which profoundly influenced Mahatma Gandhi’s economic and social thinking. Ruskin’s principles, particularly that “wealth consists of things in themselves valuable; that which avails for life is better than that which avails for money,” deeply impacted Gandhi’s approach to social welfare and healthcare. Gandhi was so moved by this work that he translated it into Gujarati as “Sarvodaya” (welfare of all), incorporating its principles into his vision for India’s healthcare and social development.[5,6] The key principles from “Unto This Last” that align with sustainable healthcare approaches include: The true wealth of a nation lies in the health and well-being of its people, not merely in its monetary resources The value of labor extends beyond economic returns, to include social and personal well-being The welfare of the individual is inextricably linked to the welfare of all. As we move forward, this holistic understanding, grounded in both ancient wisdom and enlightened economic thinking, could help bridge the gap between traditional wisdom and modern medical necessities, potentially revolutionizing how we approach healthcare delivery in limited-resource settings. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Institution: All India Institute of Ayurveda, New Delhi
Language: English
Subfield: Finance
Domain: Social Sciences
Open Access status: diamond
OpenAlex ID: W4412484819