Right to health

Health concerns as critical as those for education and food

Nearly 70 per cent of Indians have to meet their expenses on healthcare and medicines out of their own income, says a recent report of the World Health Organisation (WHO). This exposes the appalling state of the country’s public healthcare system and inadequate public spending on health services. Leaving aside the rich welfare states, where governments take care of all or the bulk of the health needs of their citizens, India compares poorly in this respect even with its not-so-rich neighbours in Asia, where hardly 30 to 40 per cent of an individual’s health expenses come out of her pocket. The consequences of such a dismal state of affairs are disturbing. The WHO report has far more damaging findings that should wake up our government. About 3.2 per cent of Indians are pushed into poverty annually because of high medical bills. Worse, about 30 per cent of the rural people in India do not seek cures for their ailments because of the financial costs involved. In urban areas, too, about 20 per cent of diseases remain untreated due to unaffordable costs. A sizable proportion of hospitalisation cases in both rural and urban areas are funded by loans and sale of assets.

Indeed, the health issue, in its broader perspective, cannot be viewed in isolation from sanitation and access to clean potable water, since these aspects are critical for prevention of several dreaded diseases. Unfortunately, the country’s track record on this count is also poor and does not inspire confidence. A World Bank-supported study has estimated the economic impact of inadequate sanitation in the country at around 6.4 per cent of the gross domestic product (GDP). This apart, some of the diseases which were once eradicated, such as malaria, have staged a comeback simply because there was no sustained preventive drive after their eradication. In addition, several new and relatively more dreadful ailments, which were unheard of till a few years ago, such as dengue, chikungunya, meningitis and the like, have surfaced and assumed threatening dimensions. The genesis of this worrisome situation can, indeed, be traced to the steady shrinkage in government spending on health care. It has plummeted from around 1.6 per cent of the GDP in the mid-1980s to less than one per cent now. As a result, the overall public health infrastructure has remained underdeveloped vis-à-vis the needs of the large population.

Besides, most government hospitals and rural primary health centres have remained understaffed, ill-equipped and starved of essential drugs. It is believed that a marginal hike in investment in drug procurement, from the present meagre 0.1 per cent of GDP to 0.5 per cent, can ensure universal access to at least the essential drugs, easing the burden on private expenditure to a considerable extent. Though it can be argued that the private healthcare sector in India has grown rapidly in terms of infrastructure as well as quality of service and has begun to attract patients from abroad, this remains largely inaccessible to the poor because of high costs. What is perplexing is that a country which has chosen to give its people the statutory right to education and is planning to do the same for food, the right to an equally important fundamental need like health and sanitation is being disregarded. What needs to be acknowledged is that an increase in investment in public health is bound to yield handsome returns by way of improving the productivity of people and reducing economic losses due to health factors.