If the modern human harbors illusions of immortality, it is largely because of medicine. The miracles that medicine has worked on humanity, in the larger and much broader perspective, have been nothing short of life-saving. This is a literal expression. Lives have been saved and the spirit of doing something impossible has led to the boundaries of human entrepreneurship being pushed beyond the wildest dreams for a huge chunk of mankind. This explosion in medical knowledge and consequent advancements have dominated the netspace and has led to several tangential questions: about the right to access to affordable medicine, the rights of the care-givers to proper pay, increasingly complex ethical and moral dilemmas regarding patents and medical monopolies et al.
It is absurd today to think that a common headache, which can be expelled from one's body faster than hurt feelings, used to be once thought of as the a person possessed by an evil djinn, a cruel spirit upon whom the person had committed grave injustice when the said djinn was mortal. Today, it is a simple matter of taking the proper cure at the proper time, with even cancer and HIV being surmountable. The very idea of someone dying from a common cold and fever is now dismissed blithely, while the fear of death and disease loomed large and cast gaunt shadows all over the world during the middle ages - the most famous being the Spanish Influenza of 1918, where the same disease claimed over 20 million lives. Since the 20th century, human life has become easier to preserve and although millions toil away trying to do something productive with their life, the ever-advancing frontiers of medical solutions are instilling a feeling of complacency towards mortality.
However, one must ask, has life and the ‘standard of living’ which we all so anxiously care for, really taken off as much as we would like to believe? Has medicine been circulated and utilized as efficiently as it can be? I argue for the contrary.
It is easy to assume a generality, to labor under the illusion that access to medicine and healthcare is universally granted, and is enjoyed by all of mankind without the slightest discomfort and struggle. It is however wholly unreal and unwise to assume so. In many areas of the world, most visibly in Africa and Asia, access to the most basic of antibiotics and antiseptics is an onerous task, and the standards and quality of life has not taken off quite as well as some of the developed countries. In our own country, we have a vast populace who find it difficult to meet the back-breaking demands of private hospitals. It is weak and obnoxious to dismiss the woes of these swathes of population across different parts of the world with simplistic concepts like a simple wave of "The government should implement better reforms", "The society should do more for the less fortunate", and "This party is responsible for stalling the reforms in Parliament". All of the above pithy statements may be very true in their own regard, but fail to garner strength and momentum in the long run, and eventually peter out in light of yet more outrages and offenses committed against the public at large.
The need for an active implementation of policy reforms in this regard is immense. Our nation cannot sustain financial richness and digitalization of life without strong roots in healthcare and an efficient system that equalizes the opportunity of healthcare among all people. As a layperson, I believe that issues like poverty and lack of access to efficient healthcare are grounded in the deep waters of economy and employment, and to be dismissive of the underlying circumstances around access to healthcare would be foolish. The skewed nature of income and wealth itself leads to a disproportional distribution of standards. There are people struggling to make ends meet and gain access to food and water, while in a mere 50-100 kilometers away, people can afford to put their parents in a 'home', unwilling to look after them. The sheer injustice, one would say. I suppose it is.
The root for this problem is the out-of-pocket (OOP) spending in India. Healthcare and medicine runs on the fees paid out of the common man’s pocket, and for the lesser well off, this is all the more difficult as they often have to bend over backwards trying to meet the exorbitant claims of the private sector, in search for better quality of treatment. This is a result of the glaring lack of funds in the public sector, i.e. the government-run sector of healthcare. The general apathy towards the healthcare is evident in the budget allocation by the past few successive Parliaments.
India spends 1.2% of its GDP on public spending on healthcare, which is the second-least of all South Asian countries, beating only Pakistan. Countries with low income capital such as Sri Lanka and Bangladesh have successfully spent more for their GDP on healthcare than India. In 2010, the UPA government allotted Rs. 22,300 crore, which was very low as compared the sector of Rural Development, which received a whopping Rs. 66,100 crore. This was followed by a rise in 2013, when Rs. 37,330 crores was allotted for healthcare. In 2014, the budget for healthcare sector was slashed by 20%. In 2015, the budgetary allotment of the Central Government had set aside a mere Rs. 33,150 crore for basic healthcare in India, falling from the already low Rs. 35,164 crore allotted in 2014-15. There was a boost in favor of private hospitals though, the government increased the cap of deductions from Rs. 15,000 to Rs.25,000 on health insurance claims, which is clearly aimed at incentivizing people to opt for private hospitals rather than public hospitals.
The aim of the government should be to make public healthcare accessible and safe for people of all classes to use. Instead, allotment for the Integrated Child Development Scheme was halved from Rs. 16,000 to Rs. 8000 crore, the NACO had its allocation cut by Rs. 400 crores and the ambitious National Health Assurance Mission, announced by the government, has come to a stuttering halt in many states, including UP, where the NRHM, an initiative founded under the erstwhile Congress regime in 2005, is already midst corruption charges. The present government’s manifesto itself stressed the term ‘health assurance’, a vaguely worded epithet that has even vaguer implementation. The opening of five more AIIMS in India was the sole respite for those advocating public healthcare and anguished by successive governments’ apathy to the same. These problems are not strange to the present government alone, but have been recurring in India over several years. The priorities of the State, rather than the government in charge, are to be questioned.
A society is only as strong as the weakest links, and judging by the weightage attached to its decisions, I would have to say that right now, the government is the weakest link in the community. Several scholars (including Amartya Sen, in his book An Uncertain Glory: India and Its Contradictions) make a consistent claim for a Universal Healthcare Care model, asking the government to take charge of education and healthcare, and it is precisely these sectors in India that are increasingly being out-sourced /surrendered to the private sector. A State-sponsored system of healthcare shall stifle the motives of profit maximization currently witnessed everywhere, and may lower the inordinately impossible bar required by many private hospitals. That is, if the State moves beyond the motives of profit-maximization, as it invariably seems to do. An efficient State is the ultimate aim, and has the potential to realize dreams and actualize fiction.
Today, it would be deemed as fiction if I proclaim that within 2030, India shall be an educated country, with a creative and robust youth, all of whom can afford basic healthcare and an assurance over protection of life, limb and the future, equating them to that percentage of man today that knows that tomorrow shall come. I fervently hope that this statement is actualized.
(The writer is a second year student at NALSAR University of Law).