[Editorial Analysis] COVID-19 and a country club India must leave

Mains Paper 2: Health
Prelims level: Not much
Mains level: Issues relating to development and management of Social Sector/Services relating to Health

Context:

• Billion Indians have experienced the pandemic sweeping and harming the lives of vulnerable in our country.

• East Asia and Europe where the virus threatened and devastated have recovered well.

• India isn’t alone in failing to contain the pandemic. We have Trump’s U.S. and Bolsonaro’s Brazil to give us company.

The poison of inequalities:

• All these three are populous, federal, diverse and democratic.

• These three countries share is the toxic levels of historic inequalities which affect every structure of society including, most importantly, the health-care system.


The value of investing in a just public health-care system has never been as starkly obvious as now.
• To be sure, there have been far deadlier epidemics which continue to kill many more people than COVID-19.

• Diseases like HIV, diarrhoeal diseases and tuberculosis, have mostly killed the poor and the marginalised, outside the conscious radar of those in power.
• More to the point, no previous epidemic brought the engines of the economy to a standstill.

• If some poor person died of a horrible disease in some slum, C-grade town or village in the back of beyond, the stock market could not care less.

• However, on this occasion, for the first time, the wealthy and the powerful in their urban palaces have found themselves under pressure.

• And their high-tech doctors and “super-specialist” hospitals can do little to rescue them.

On universal coverage:

• What differentiates countries which have recovered from Covid from those, like ours, which remain still affected, is the commitment by both the state and civil society to the principles of universal health coverage.

• To be fair, if universal health coverage was understood with the simple existence of a publicly financed health-care system, then India, like the United States and Brazil, can already boast to have met this goal.

• However, this is not what universal health coverage means in spirit.

• Only a system which all people, rich and poor, those in power and those who are powerless, can rely on to be given care with the same quality regardless of their station in society, can be truly considered “universal”.

A question of quality:

• Such a universal health coverage system does not exist in India, or the U.S. or Brazil.

• More than half the population in these countries, concentrated in the upper income groups, seeks health care in the fee-for-service private sector.

• The private sector in India provides almost 80% of outpatient and 60% of inpatient care, as a result of which falling ill is one of the most important contributors to indebtedness in the country.

• Health care in India has become a leading cause of poverty.

• Universal health coverage is recognised by many countries as a strategy to empower people to lift themselves out of poverty.

• It is also the foundation of sustainable development.

• The fact that, despite this knowledge, the majority of our people prefer private care, is a hurting evidence to their experiences of the public health-care system.

Major problems:

• The titans of corporate medicine in India justify their costs by arguing that these are much cheaper than in the U.S. or Europe.

• Such comparisons are ridiculous as they are oblivious of the fact that India’s per capita income places us as one of the poorest countries in the world.

• The clearly visible ills of the wholesale commercialisation of health care, standards of our infrastructure needs to be taken care.

• There are a host of other challenges to realise universal health coverage, the honesty and competency of health-care workers which contribute to the abysmal quality of care, in both the private and public sectors.

• The pandemic has brought the scandalous quality of our health-care system to the fore.

• Stories of pigs roaming freely and the absence of doctors in public hospitals to shameless profiteering and refusal to care by private hospitals are emerging out.

• The proclivity of doctors to irrational medical procedures and drug prescriptions, the lack of dignity with which the poor are cared for, and the corrupt practices are well documented.

No accountability:

• At the heart of this pathetic state of affairs is the complete lack of accountability of either the private or public sector.

• And the absence of the stewardship role of the state in ensuring justice and quality of health care for all its citizens.

• It comes as no surprise that there is a fundamental breakdown of trust between civil society and the health-care system, exemplified at its most extreme by violence against health-care providers.

• Fixing the rot will need structural reforms far beyond the top-down “missions” and knee-jerk punitive actions which have dominated our policy-making for over 70 years.

• But for this to happen, we will need a broad coalition across the political establishment and civil society, in particular the wealthy and ruling classes, to demand change.

Conclusion:

• It is clear as how a dysfunctional, fragmented and unaccountable health-care system will ultimately destroy the economy itself.

• Even if the pandemic has hit the poor the hardest, it has also crippled the nation.

• But we need more than just new money for while health care is the wisest investment for the economy.

• Such an investment must be accompanied by a social compact that the same system caters to all.

• This philosophy of universal health coverage is already practised in diverse ways, including engagement of the private sector, by scores of countries.

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Prelims Questions:

Q.1) With reference to the e-commerce, consider the following statements:

1. All e-commerce entities have to ensure the mandatory declaration of country of origin of imported products sold on their respective sites.

2. The law relating to the issue was enacted under the Legal Metrology Act, 2009 and the Legal Metrology (Packaged Commodities) Rules, 2011.

Which of the statements given above is/are correct?
(a) 1 only
(b) 2 only
(c) Both 1 and 2
(d) Neither 1 nor 2

Answer: C

Mains Questions:

Q.1) In light of COVID-19 pandemic, know about what are the inequalities and similarities between the top three pandemic affected nations?

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