GS PAPER II EDITORIAL
India needs a renewed health-care system
Why in News
- Recently, India appointed ne health minister after the recent cabinet reshuffle.
Two states comparison
- For any population, the availability of functional public health systems is literally a question of life and death.
- Recently, Kerala and Maharashtra per capita gross state domestic product (GSDP) reflects each state’s overall economic status, which is comparable.
- However, their COVID-19 case fatality rates are vastly different, with Kerala’s at 0.48 percent and Maharashtra’s at 2.04 percent, implying that a COVID-19 patient in Maharashtra is over four times more likely to die than one in Kerala.
- A major reason for such critical divergence is likely to be the huge differences in the effectiveness of public health systems.
- Kerala has per capita two and a half times more government doctors, and an equally higher proportion of government hospital beds when compared to Maharashtra, while allocating per capita over one and half times higher funds on public health every year.
- Despite Maharashtra having a large private healthcare sector, its weak public health system has proved to be a critical deficiency.
- Whereas. robust government healthcare services in Kerala are more effective outreach, timely testing, early case detection and more rational treatment for COVID patients, which all together reduce fatality rates.
- Existing evidence from the COVID19 pandemic provides that negligence of public health systems can mean largescale, avoidable losses of lives; hence, public health services must be upgraded rapidly and massively as a topmost priority.
Dealing with Public Policy on Health
- The National Health Mission (NHM) is a larger programme that requires the Health Minister’s immediate attention; since 2017-18, Union government allocations for the NHM have decreased in real terms, resulting in insufficient support to States for core activities such as immunisation, and systemic gaps are affecting the delivery of COVID-19 vaccination.
- The condition of the National Urban Health Mission (NUHM) remains pathetic. The Central funding for the NUHM this year is Rs 1,000 crore, or less than Rs 2 per month each urban Indian.
- This situation must change, and as recommended by the Parliamentary Standing Committee, for reaching National Health Policy targets, the Government must allocate ₹1.6lakh crore for public health during the curre year.
- This would amount to a doubling of the present central health Budget, which could enable major strengthening of health services in rural and urban areas across the country.
Private sector Regulation
- Massive hospital fees have wreaked havoc on the middle class; COVID-19 treatment can cost anywhere from Rs. 1 lakh to Rs. 3 lakh per week in large private hospitals.
- The ‘Remdesivir panic’ was significantly linked with major overuse of this medicine by unregulated private hospitals, despite the drug lacking efficacy to reduce COVID19 mortality.
- Although various determinants have contributed to the Mucormycosis outbreak, irrational use of steroids in COVID19 patients, especially diabetics, appears to be an important factor.
- Despite of all this, the central government has yet to take the essential steps to promote the Clinical Establishments (Registration and Regulation) Act’s implementation (CEA).
- Passed in 2010 and presently applicable to 11 States across India, this act is not effectively implemented due to a major delay in notification of central minimum standards, and failure to develop the central framework for regulation of rates.
NITI Aayog Prescription
- NITI Aayog has recently published the document, ‘Investment Opportunities in India’s Healthcare Sector’ which promotes further privatisation of health care in a country which already has one of the most privatised health systems in the world.
- But this report fails to acknowledge the negative aspects of unregulated private health care; neither is there any mention of the need for regulation of private hospitals.
- Instead, the document celebrates the COVID19 epidemic as a prime business opportunity to be exploited, stating that ‘in the hospital segment, the expansion of private players to Tier 2 and Tier 3 locations, beyond metropolitan cities, offers an attractive investment opportunity’.
- Proposals for handing over public hospitals to private operators, who would presumably now run these key public institutions on commercial lines under the ‘Viability Gap Funding’ scheme are deeply worrisome, especially since public health services which were hitherto free of cost, would begin to be charged for.
- Assuming that the Union Health Ministry has a primary mandate to shape national health policy in India, the health minister must assert his authority to stop such moves for further privatisation, which might benefit healthcare corporates but would be damaging for ordinary people.
Conclusion
- This is a time when it is critical to rebuild people’s trust in public health systems. This would help in overcoming COVID19 vaccination hesitancy while strengthening the promotion of healthy behaviour necessary to deal with the current wave of COVID19 and prevent a third wave.
- This would be done best if the new Health Minister acts on three core health system lessons of the COVID19 pandemic — a need for strengthening public health systems; regulating private health care, and preventing further privatisation of the health sector.
- It is not unjustified to expect our new Health Minister to present an example to the people of India, by acting decisively for public health systems.
GS PAPER II
Overdue review
Why in News
- While indicating its desire to reconsider the IPC’s sedition provision, the Supreme Court posed the most pertinent question: “Why does Section 124A remain on the statute book even after 75 years of independence?”
- The Chief Justice of India has raised concerns about its widespread abuse by police across the country, reminding the government that it was a legal provision that the colonial regime had used to suppress freedom movement.
Misuse of Sedition Provision
- The questions raised by the CJI may set the tone for a broad re-consideration of a section that has been abused, especially in recent years, to repress dissent, criminalise vehement political criticism, and label opponents as “anti-national.”
- Even though it is argued that the misuse of law does not render it unlawful, there is a compelling case for striking down Section 124A due to its inherent propensity for abuse.
- All regimes have a pattern of behaviour that indicates a predisposition to invoke it without first assessing its application to the facts of any case.
- Recent cases show that sedition is used for three political purposes:
- To silence criticism and protests against the government’s policies and projects,
- To criminalise dissenting opinion from human rights defenders, lawyers, activists, and journalists, and
- To settle political scores, sometimes with communal hues.
Way forward
- A Constitution Bench upheld sedition in 1962, limiting its scope to only those instances of speech or writing that show a pernicious tendency to cause public disorder by reading down the meaning of the terms “bring into hatred or contempt” or “to create disaffection towards the government established by law.”
- Several cases have been brought before the Court asking for a reversal of the 1962 decision, citing more recent judgements broadening the scope of fundamental rights and doctrines that have since emerged.
- The “chilling impact” that a legislation can have on free speech, as well as the ambiguous and “overbroad” definition of sedition that makes both controversial and innocuous speeches or writings equally vulnerable for prosecution, are all issues that should be considered.
- The government admitted in Parliament in 2016 that the concept of sedition is overly broad and needs to be reconsidered.
Conclusion
- While issuing fresh guidelines and safeguards is one way of quelling the potential for its misuse, it will be more helpful if Section 124A is struck down altogether.