Dr
Arun Mitra
Health
is the basic human right. Every person has the right to live a healthy life and
contribute effectively to the society’s development. As right to health is
included in the directive principles, it becomes the duty of state to provide
comprehensive universal healthcare to all citizens. It has to ensure prevention
of disease, promotion of good health and rehabilitation of the diseased and the
infirm.
Nutrition
is the key to health. A poorly nourished person is more likely to be taken ill.
Therefore prerequisites for a healthy life are safe drinking water, proper
sewerage facilities, balanced nourished food with sufficient calories and other
nutrients, proper housing and healthy environmental surroundings. There is need
for special care for women, children and the elderly. Unfortunately we are far
from meeting these requirements. Our hunger index is 103 out of 118
countries. This is a serious matter. How
do we expect children with stunted growth to build a healthy developed
nation?
Various
studies have concluded that to ensure comprehensive primary healthcare there is
need to enhance public health spending on health to minimum of 5 per cent of
the GDP. As per the National Health Accounts (NHA) Estimate for 2014-15, the
Government Health Expenditure (GHE) per person per year is just Rs.1108/-. This
is in contrast to the Out of Pocket Expenditure (OPE) of Rs.2394/- which comes
out to be 63 per cent of total health expenditure which is Rs.3286/- per
person. Even this expenditure is not
homogenous. The spending on health varies on
socio-economic status, gender, religion, caste and geography.
The
average share of OPE on health care as a proportion of total household monthly
per capita expenditure was 6.9 per cent in rural area and 5.5 per cent in urban
area. This led to an increasing number of households facing catastrophic
expenditure due to health costs. More than 40 per cent of the population has to
borrow or sell assets for treatment. This is totally against the principles of
equity and justice. Already marginalised sections, Dalits, Muslims and other
socio-economically weaker groups are worst affected.
Flaws
in planning and implementation of the policies have been pointed out by the
Comptroller and Auditor General of India (CAG) in 2017. The audit pointed
towards inadequate funding, under-spending of available financial resources,
delays in transfer of funds, diversion of allocated programme funds, limited
capacity to spend due to shortages in infrastructure and human resources among
other issues.
The
recently launched National Health Protection Scheme (NHPS) aims to cover almost
half the population with publicly funded health insurance. The private health
insurance companies and health care providers are already expecting huge
dividends from NHPS. There is also proposal for Health and Wellness Centres
(HWC) to deliver preventive, promotive, curative and rehabilitative services.
With a low financial allocation this will not take up. There is shift from
public provisioning of health towards privatisation.
To
improve the health of the people drastic steps need to be taken at various
levels. Health should be declared a fundamental rights irrespective of
religion, age, sex, cast and socio economic status. The government owes its
responsibility to deliver health to all by ensuring universal access to quality
healthcare, education and other day to day needs. For this they should be
continuous evaluation of health status of the people. Health should get proper
place in the political agenda and the policy making bodies.
Certain
steps that need urgent action is the rationalization of drug prices. Regulate
drug prices in line with the rationalization of trade margins in medical
devices. The ex-factory cost of the drugs should be actual cost based. Cap
trade margin on drugs and medical devices to a maximum of 30 per cent.
Provide
free medicines and investigations in all public hospitals on the lines of Tamil
Nadu, Kerala and Rajasthan. Pledge to increase the public expenditure on
healthcare from 1.1 per cent to 2.5 per cent of GDP immediately and then
increase it to 5 per cent in subsequent five years.
Medical
education has to be revamped and within approach of all sections. Regulate
tuition fees of 100 per cent seats in private medical colleges.
The
Constitution guarantees six fundamental rights to Indian citizens as follows:
(i) right to equality, (ii) right to freedom, (iii) right against exploitation,
(iv) right to freedom of religion, (v) cultural and educational rights, and
(vi) right to constitutional remedies.
Fundamental
Rights are justiciable, as they can be enforced, whereas the directive
principles are non-justiciable, in that, they are not enforceable in the court
of law. It is high time the health is
included as one of the fundamental rights. (IPA
Service)
The post Make Right To Health A Fundamental Right appeared first on Newspack by India Press Agency.
