Monday, 29 April 2024 11:21

Health Care: Claims and Reality

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Claim:

"… in the last ten years, holistic healthcare has been one of the top priorities of the government"

Reality

Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana

Under the Modi regime, there is basic shift in the health sector.  India’s National Health Policy based on WHO’s declaration to achieve ‘Health for All’ i.e. free universal public healthcare system is being replaced by insurance-based healthcare system. Government’s role has been changed from being a provider health, a basic need of the people, to a financier of private health business. That is the reality of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana for the poor. Instead of strengthening the public health infrastructure, the central and state governments pay insurance premium @60:40 ratio to the insurance companies. An investigation under the Right to Information by The Indian Express revealed that two thirds of the total money spent went to private hospitals. As is well known, the cost of hospitalisation in private hospitals is several times that in government hospitals. At the same time, it is reported that over 85% people in rural areas and 80% people in urban areas are not covered by any health scheme.

Health Budget

National Health Policy 2017 set the benchmark of increasing government expenditure on health to 2.5% of GDP. However, the share of total government expenditure on health still hovers around 1.30% to 1.40% of GDP while the allocation for health in the Union Budget has remained stagnant at a measly 0.3%.

According to a WHO report published in 2022, Indian people spend 53% of the total expenditure on health in the country, (which includes the cost of infrastructures, instruments, medicines, payment for doctors and staffs) from their own pocket! Every year, 5.5 crore people in our country are pushed into poverty because of the huge unavoidable expenditure on health.

Public Health Care Infrastructure

The number of health subcentres, primary health centres (PHCs) and community health centres (CHCs) is highly inadequate

The Rural Health Statistics (RHS) 2021 released by Central government itself showed that, the shortage of doctors in CHCs has risen from 45% in 2005 to 80% in 2021; there is a 7% shortfall of doctors at Primary Health Centres (PHC). Almost two-third of the country's population resides in rural areas but only 33% of the total health workers and 27% doctors are available in rural areas. Instead of strengthening public health infrastructure, the government is resorting to privatisation of PHCs, CHCs etc through the PPP route. Is it not a crime on people?

In July 2022, the government said in Lokasabha that it was setting up 22 new All India Institutes of Medical Sciences under the Pradhan Mantri Swasthya Suraksha Yojana. As of now, only seven AIIMS are fully functioning in the country – one is the first AIIMS established in Delhi in 1956; the other six were set up under the UPA regime.

Increasing Cost of Medicines

The first National Drug Policy based on the Hathi Committee’s recommendations was aimed at providing medicines at affordable prices. This was revised several times and diluted since the advent of neoliberal policies. The Modi government has changed the very concept of cost based pricing of medicines to market based pricing. Medicine prices are fixed at average market prices of high profile branded products having more than 1% market share and allowed to freely increase their prices by 10% every year. Medicines are subjected to high taxes, based on retail prices and not on production cost. Retail prices are often 100% to 500% more than the production costs. It has also removed the States’ option of free Sales Tax on medicines. 

Disastrous Response to Covid Pandemic

In the initial phase, the Modi government, instead of promoting scientific approach to the pandemic among the people resorted to gimmicks and utterly unscientific calls like beating of plates, putting lights on and off etc. It failed to strengthen the health infrastructure before the second wave of Covid struck. As a result, thousands of people died due to lack of oxygen and hospital beds. The images of people dying on pavements outside hospitals as hospital beds were still alive in our minds, of bodies floating on rivers as people could not afford cremation, can never be forgotten.  And in that process,  seven new billionaires in the healthcare and Pharma business has emerged in our country.

Health is a basic need of the people and it is the responsibility of any elected government to ensure universal free health care for all its citizens. The corporate communal nexus represented by the Modi government has not only totally neglected this responsibility; it has made a lucrative business for the private health-tycoons; it has been promoting unscientific thinking, making false claims and spreading lies. This BJP government led by Modi must be defeated to strengthen united struggles for universal free health care 

Use your vote! Decisively defeat the BJP and its allies! Strengthen the Left in the 18th Parliament!

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