Content
- India’s demographic dividend as a time bomb
- Building health for 1.4 billion Indians
India’s demographic dividend as a time bomb
Basics / Background
- Rabindranath Tagore’s Quote: Children must not be restricted to past learning; they are born for the future.
- Present context:
- India’s education system remains outdated, exam-centric, and degree-driven.
- The future of work is being shaped by AI and emerging technologies.
- Demographic Dividend:
- India has 800+ million people under 35.
- This can be an asset or a liability depending on education–employability alignment.
Relevance : GS 1(Society ),GS 2(Social Issues)
Practice Question : India’s demographic dividend risks turning into a demographic disaster unless education and employability are aligned. Critically examine.(250 Words)
Why the Crisis Exists
- Curriculum lag: Update cycle in schools/colleges = 3 years, whereas job requirements evolve faster.
- Outdated pedagogy: Focus on rote learning, not problem-solving or practical application.
- Career unawareness:
- 93% students (class 8–12) know only 7 career options (doctor, engineer, lawyer, etc.).
- Economy actually offers 20,000+ career paths.
- Skills gap in graduates:
- Only 43% graduates job-ready (Graduate Skills Index 2025).
- 40–50% engineering graduates remain unplaced.
- Even STEM students lack industry-required skills.
Impact of AI & Automation
- McKinsey estimate: By 2030, 70% of Indian jobs at risk from automation.
- World Economic Forum: AI may create 170 million jobs by 2030, but 92 million will be displaced → Net gain possible only with reskilling.
- Nature of change:
- 30% of tasks in existing jobs → automated.
- New opportunities in AI development, data science, robotics, cyber-security, green jobs.
Government Efforts
- Skill India Mission (2015): Target 400 million by 2022 → fell short due to poor monitoring, fragmented implementation.
- Other schemes:
- PM Kaushal Vikas Yojana (PMKVY)
- PM Kaushal Kendras (PMKK)
- Jan Shikshan Sansthan (JSS)
- PM Yuva Yojana (PMYY)
- SANKALP, PM Internship Scheme
- Problem: “Acronym soup” of schemes, poor integration, low awareness, weak industry linkages.
Challenges in the Current Education System
- High school problem:
- Lack of career counselling (only 7% get formal guidance).
- Curricula exam-driven, not skill-driven.
- Higher education disconnect:
- Degrees ≠ employability.
- Employers face skill shortage despite mass graduation.
- Digital divide: Smartphones common, but teaching mindset remains analog.
- EdTech limitations: Focus on test prep, not skill development → certificates commoditized.
Risks if Unaddressed
- Demographic time bomb: Educated but unemployable youth → unrest & instability.
- Historical parallel: 1990 Mandal Commission student protests → violent unrest.
- Lant Pritchett’s “Where Has All the Education Gone?”: Education without employability leads to wasted human capital.
- Social contract under threat: Youth disenchantment can escalate into economic, political, and social crises.
Way Forward
- Curriculum Reform:
- Integrate AI, data science, coding, green economy, critical thinking at school level.
- Update cycle must be continuous, not once in 3 years.
- Career Guidance:
- National framework for career exploration in schools.
- Awareness of 20,000+ modern career paths.
- Industry–Academia Linkage:
- Courses co-designed with industry (apprenticeships, internships).
- National Skill Universities with strong private sector partnerships.
- Skilling Ecosystem Reform:
- Merge fragmented schemes into one National Skill Grid.
- Outcome-based measurement (placement %, not training numbers).
- Digital Integration:
- AI-driven personalized learning platforms.
- Expand access to rural areas through PM e-Vidya, SWAYAM, DIKSHA.
- Public–Private Collaboration: EdTech + Government + Industry partnerships for real-time skill delivery.
- Youth Empowerment Policy: Embed reskilling, upskilling, cross-skilling in National Education Policy (NEP).
Building health for 1.4 billion Indians
Background
- Health-care paradox in India:
- Rising demand for affordable & accessible care.
- Growing burden of non-communicable diseases (NCDs) (diabetes, hypertension, cancer).
- Uneven distribution of services (urban vs tier-2/3 cities).
- Demographic reality:
- Large, young population → increasing health needs.
- Aging population by 2047 will further stress the system.
- Core challenge: Dual task of expanding access and ensuring affordability.
Relevance : GS 2(Health , Social Issues)
Practice Question : Insurance, prevention, and digital innovation are the three pillars for building a resilient healthcare system in India. Discuss.(250 Words)
State of Insurance & Affordability
- Insurance as foundation:
- Pooling risk → shields families from catastrophic health expenses.
- Even modest premiums (₹5k–20k individual, ₹10k–50k family) = several lakhs coverage.
- Current status:
- Only 15–18% insured.
- Insurance premium-to-GDP ratio 3.7% (India) vs 7% (global average).
- Potential:
- $15 billion gross written premiums in 2024 → projected 20%+ CAGR till 2030.
- Problem:
- Insurance mostly crisis-driven; not integrated with everyday care, outpatient needs, prevention.
Efficiency & Scale
- India’s unique model:
- Extraordinary efficiency in healthcare delivery at scale.
- Example: MRI machines → 7–8 scans/day in West vs many times more in India.
- Rooted in: doctor-patient ratios, workflow innovation, infrastructure utilisation.
- Next leap:
- Extend this efficiency to tier-2 and tier-3 cities (currently underserved).
- If successful → India sets a global benchmark for affordable scale healthcare.
Role of Government Schemes
- Ayushman Bharat – PM Jan Arogya Yojana (PM-JAY):
- Covers 500 million people.
- Provides ₹5 lakh/family/year for advanced care.
- Enabled millions of cashless treatments.
- Example: Cancer treatments for beneficiaries ↑ nearly 90%.
- Need: Expand private hospital participation with fair reimbursements + transparent processes.
- Ayushman Bharat Digital Mission (ABDM):
- Aims at universal health records → continuity of care across public + private providers.
Prevention as the Cost-Saver
- Rising burden of NCDs: Major share of OOP (out-of-pocket) expenditure.
- Punjab study: Even insured families → catastrophic spending on diabetes, hypertension, etc.
- Solution:
- Insurance redesign → cover outpatient & diagnostics.
- Nationwide prevention push → lifestyle, diet, screening.
- Public participation → schools, employers, communities promoting preventive health.
- Logic: Every ₹1 spent on prevention saves multiples in future treatment costs.
Digital Transformation in Health
- Telemedicine & AI adoption:
- Remote consultations (bridging urban specialists with rural patients).
- AI tools → detect sepsis early, triage reports, optimise workflows.
- Impact:
- Democratise access → reach rural & underserved.
- Increase doctor productivity.
- Enable universal digital health records (under ABDM).
Regulation & Trust
- Challenge: Rising costs due to environmental & lifestyle factors.
- Eg: Insurers considering 10–15% premium hike due to pollution-linked respiratory illness.
- Importance of regulation:
- IRDAI urged to strengthen claims settlement, grievance redress.
- Trust is key → without confidence, households won’t buy insurance.
- Balance required: fair pricing + transparent processes.
Investment & Inclusion
- Private investment: $5.5 billion (2023) in health (digital, pharmacy, hospitals).
- Problem: Concentrated in metros.
- Way forward: Redirect capital to tier-2/3 cities, primary networks, training specialists.
- Outcome: Growth → inclusion, not just elite urban healthcare.
Risks if Challenges Persist
- Low penetration → continued catastrophic out-of-pocket (OOP) expenditure (~55% of health spending).
- NCD tsunami → overwhelming public + private health system.
- Urban-rural divide widens → inequity, social unrest.
- Trust deficit → poor adoption of insurance, loss of financial protection.
Way Forward
- Insurance:
- Expand beyond inpatient → outpatient, diagnostics, preventive care.
- Incentivise preventive behaviour (premium discounts for healthy lifestyle).
- Primary Healthcare Strengthening:
- More Health & Wellness Centres (HWCs).
- Focus on NCD screening.
- Digital push: Scale telemedicine, AI diagnostics, ABDM adoption.
- Public-Private Partnerships (PPP):
- Private hospitals in PM-JAY with fair reimbursements.
- Joint investments in tier-2/3 healthcare infrastructure.
- Workforce training: More doctors, nurses, allied health professionals, especially in rural India.
- Regulation: Stronger IRDAI framework for claims settlement & pricing transparency.
- Equity focus: Direct PE/VC flows to underserved geographies.
