CONTENT:
- One Earth, One Health
- India Needs Deep Industrialisation
One Earth, One Health
Context:
India’s adoption of the ‘One Earth One Health’ slogan reflects its commitment to enhancing health infrastructure. This approach emphasizes comprehensive health protection for all living beings, encompassing humans, animals, and plants. Additionally, the Indian government has prioritized making medical treatment more accessible.
Relevance:
GS2- Health
Mains Question:
The Government’s vision of ‘One Earth, One Health’ rooted in ancient Indian philosophy reflects India’s enduring commitment to universal health as showcased in its health oriented schemes. Comment. (15 Marks, 250 Words).
Ayushman Bharat Scheme:
About:
- The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is a flagship health protection initiative initiated by the Indian Government in 2018.
- Its objective is to provide comprehensive health coverage to economically disadvantaged sections of society, ensuring equitable access to high-quality healthcare services.
- This initiative has the potential to revolutionize the nation’s healthcare sector by alleviating poverty, increasing productivity, and fostering social equity.
Main Objectives of AB-PMJAY:
- Alleviate the financial burden of out-of-pocket expenditure (OOPE) on healthcare for beneficiaries.
- Enhance access and affordability of healthcare services for beneficiaries.
- Improve the quality and efficiency of healthcare delivery systems in the country.
- Promote preventive, promotive, and curative health interventions for beneficiaries.
Key Features of AB-PMJAY:
Health Coverage:
The program offers health coverage of Rs 5 lakh annually per family for secondary and tertiary care hospitalization, benefiting over 12 crore families (bottom 40% of the population).
Medical Packages:
Encompassing 1,949 comprehensive packages, the scheme covers medical and surgical procedures for various health conditions, including cancer care, cardiac care, neurosurgery, orthopedics, burns management, and mental disorders.
Funding:
AB-PMJAY is a centrally sponsored scheme, with funding from both central and state governments, distributed at ratios of 60:40 for most states, 90:10 for northeastern and Himalayan states, and 100:0 for union territories without a legislature.
IT Platform:
Utilizing a robust IT platform, the scheme ensures seamless service delivery, prevents fraud, and includes features such as beneficiary identification, hospital empanelment, transaction management, claim management, and grievance redressal.
Hospital Network:
With a network of over 27,000 empanelled hospitals nationwide, more than half being private, the scheme encourages public-private partnerships for effective implementation.
Portability:
Interstate portability allows beneficiaries to avail services in any state with an AB-PMJAY program, aiding migrants, especially in emergencies.
Arogya Mitras:
Dedicated Pradhan Mantri Arogya Mitras (PMAMs) assist beneficiaries throughout their scheme journey, handling tasks such as verification, registration, pre-authorization, and claim submission.
Monitoring and Evaluation:
The scheme employs a monitoring and evaluation mechanism, ensuring transparency with a public dashboard for real-time tracking. Beneficiary details are published without compromising privacy, and faceless claim processing is implemented.
Anti-fraud Measures:
The National Anti-Fraud Unit (NAFU) and state-level Anti-Fraud Units use AI and ML technologies to detect potential frauds, conducting audits to maintain accountability. Over 210 hospitals have been de-empanelled for fraud or malpractice.
Call Center:
A call center verifies treatment quantity and quality within 48 hours of discharge and follows up after 15 days to assess prognosis for every beneficiary.
Evaluation:
- The ‘Ayushman Bharat’ and ‘Jan Aushadhi Yojana’ welfare health schemes alone have disbursed over Rs 1 lakh crore, benefiting predominantly low and middle-income patients.
- The implementation of Ayushman Bharat has not only spurred the demand for new hospitals but has also created opportunities for the establishment of additional hospitals and medical colleges.
- Moreover, it has catalyzed the development of a technologically driven, holistic health ecosystem.
- These revitalized healthcare efforts have significantly boosted the potential of the healthcare sector, projected to reach Rs 10 lakh crore in the future, provided there is effective collaboration between the private sector and medical academia.
- Taking proactive measures, India is now concentrating on not just treatment but also on overall wellness.
- Departing from a historical lack of an integrated, long-term health approach since independence, the current approach advocates a whole-of-government strategy, moving beyond the confines of the health ministry alone. This signals a forward-looking perspective.
- Addressing the concerns of the general populace, the government has prioritized affordable treatment, with over 10,000 Jan Aushadhi Kendras offering cost-effective medicines to those in need.
- The PM-Ayushman Bharat Health Infrastructure Mission is not only facilitating the establishment of new hospitals but also fostering the creation of a comprehensive health ecosystem.
Way Forward:
- However, a potential improvement could have been achieved through better coordination with state governments, particularly in addressing the needs of primary health centers. Unfortunately, the present ministry appears to have overlooked this aspect.
- Establishing a link between testing facilities at smaller village health centers and district hospitals could enhance healthcare services at the grassroots level.
- The emphasis on incorporating technology into healthcare presents a significant opportunity for healthcare entrepreneurs, investors, and professionals.
- The allocation of Rs 89,155 crore in the Union Budget 2023-24 has provided a renewed boost to the sector. Notably, there is a distinct shift in focus between the pre- and post-Covid situations.
Revolution in the Medical Education Sector:
- A notable revolution has taken place in the medical education sector over the past decade. The opening of more than 260 new medical colleges has resulted in a twofold increase in medical seats for undergraduate and postgraduate courses compared to 2014.
- However, there is a necessity to reassess policy decisions regarding the establishment of medical colleges, and further efforts are required to streamline the processes for Indian medical students studying abroad.
- The latest budget has also placed significant emphasis on the nursing sector, with the establishment of 157 nursing colleges around medical colleges representing a crucial step in strengthening medical human resources.
- Technologies like 5G are creating novel opportunities for startups, while drones are revolutionizing drug delivery and testing services. The medical device sector has witnessed a growth of 12-14%, attributed to initiatives such as Bulk Drug Park and Medical Device Park, along with an investment exceeding Rs 30 thousand crore in Production-Linked Incentive (PLI) schemes.
- In addition to this, introducing programs like biomedical engineering and fostering collaboration between industry, academia, and the government in IITs holds significant potential for the sector.
- However, rather than enhancing the infrastructure of primary health centers, there has been a focus on expanding patient care OPD in institutions such as AIIMS.
- Despite AIIMS being primarily recognized as a research institute, their historical contributions to the research sector are noteworthy.
Preventive Healthcare:
The government’s initiatives in preventive healthcare and awareness, such as the Swachh Bharat Abhiyan for cleanliness, Ujjwala Yojana addressing smoking-related diseases, Jal Jeevan Mission targeting waterborne diseases, National Nutrition Mission addressing anaemia and malnutrition, and an emphasis on grains through initiatives like Shri Anna, PM Matru Vandana Yojana, Mission Indradhanush, Yoga, Fit India Movement, and an increased focus on naturopathy and alternative medicine systems, including Ayurveda, have effectively prevented diseases.
Conclusion:
These government measures signify the commencement of a new era for the people and showcase India’s vision for health on the global stage. India’s vision of health was universal even in ancient times, long before global pandemics as per ancient scriptures. The Prime Minister highlighted that the concept of One Earth One Health aligns with these ancient beliefs and is a manifestation of the same idea in action, extending beyond humans to encompass a beautiful Earth for every living being, reflecting the Indian philosophy of ‘Vasudhaiva Kutumbakam’.
India Needs Deep Industrialisation
Context:
The outlook for our economic future has been reshaped by the COVID-19 pandemic. Globalization is now receding, making way for the resurgence of industrial policies and strategic state-led economic interventions worldwide. While India has sustained its growth momentum and rebounded relatively swiftly from the pandemic, it has entered a phase of ‘premature deindustrialization.’
Relevance:
GS3- Indian Economy
- Indian Economy and issues relating to Planning
- Mobilization of Resources
- Growth, Development and Employment
- Changes in Industrial Policy and their Effects on Industrial Growth
- Inclusive Growth and issues arising from it
Mains Question:
India needs deep industrialisation along with a growth of the service sector that has the power of changing the foundations of society
Studying the Changes:
- Despite the recovery, the benefits of high growth have disproportionately favored a small minority, exacerbating existing inequalities.
- While luxury cars experience high demand, ordinary citizens grapple with soaring food prices, reflecting a fundamental flaw in India’s growth structure.
- This situation prompts a longstanding question: why has India struggled to break free from industrial stagnation and generate employment?
India’s Industrialisation Journey:
- For 75 years, India has struggled to achieve significant industrialization. The contribution of manufacturing to both output and employment has consistently remained stagnant and below 20%, except for the period of ‘Dream Run, 2003–08.’
- Even the economic reforms of 1991, which aimed to promote labor-intensive industrialization, did not change this reality.
- India currently faces a critical juncture with stagnant industrial investment, high unemployment rates, and persistent disguised unemployment.
- The trade deficit, driven largely by imported goods, is widening, and India is failing to produce the goods it consumes, let alone export them.
Further Analysis:
Employment in the Services Sector:
- The employment elasticity of services-led growth is low. India’s experience with services-driven growth since the late 1980s has had two negative consequences.
- Firstly, it failed to absorb labor leaving agriculture in the same manner as manufacturing would have.
- Secondly, the service sector demanded a large, highly skilled workforce that India could not adequately supply. Although the sector absorbed some migrating labor in cities, it displayed significant inequality.
- The wages of workers with a college degree were considerably higher than those without one.
- Inequality stemming from services-driven growth is therefore much greater than that from manufacturing-led growth.
- The Gini index of inequality for regular wages in the services sector was 44 compared to 35 for manufacturing (Periodic Labour Force Survey, 2021-22).
Growth of Human Capital:
- The emphasis on higher education has led to the neglect of mass school education. These higher education institutions have nurtured self-serving elites who played a role in India’s IT “revolution” but also contributed to industrial stagnation.
- The investment in human capital has been inherently unequal, making India one of the most educationally unequal countries globally.
- According to Yasheng Huang, a Chinese economist, the lack of sufficient human capital has hindered rural Indians from initiating entrepreneurial ventures on a scale comparable to China’s rural entrepreneurship growth.
Returns on Education:
- Furthermore, the returns on education vary across social classes. While school enrollment rates are high, the accessibility of higher education is not as restricted as before. However, the differing quality of schooling directly impacts the quality of higher education, influencing labor market outcomes.
- The proposition of high-skill services primarily benefits the traditional elite rather than the majority of first-generation graduates from rural and small-town colleges. Many of these students experience meager returns on their educational investments.
- The poor quality of most state-run schools and colleges is closely tied to the elites’ disengagement from public education. These fault lines, revealing new forms of class division in India, also mirror older divisions rooted in the caste system.
The Cultural Angle:
- The absence of widespread education has resulted in a crucial cultural prerequisite for industrialization being absent. Economic historian Joel Mokyr asserts that the ascent of practical knowledge is fundamental to technological advancement and growth in contemporary economies.
- Despite expectations of foreign direct investment in India diffusing technology, this largely did not occur, except in specific enclaves. A culture conducive to growth necessitates a reassessment of the value placed on labor, production, and technology.
- India has traditionally looked down upon certain occupations, particularly those deemed essential (such as electrical work and welding), which has hindered spontaneous innovation in manufacturing.
- Industrialists argue that India undervalues the vocational skills essential for manufacturing, and some skills are not appreciated even when they command higher wages. Artisanal knowledge lacks the same social respect as scholasticism or metaphysical abstraction.
Conclusion:
Increasing returns and efficiency result from innovation and its diffusion, which are contingent on widespread education and collective absorptive capacity. India requires substantial industrialization, not just in the service sector, to wield the transformative power capable of reshaping the foundations of society.
