Context:
People look forward to budgets because they confirm the true intentions and goals of the government, i.e., who or what it “loves” more. And this assessment is based on how much the Budget contributes to ensuring that all citizens have equitable access to fundamental public goods.
Relevance
GS Paper-2 and 3: Issues Relating to Development and Management of Social Sector/Services relating to Health; Government Budgeting.
Mains Question
Examine the effects of underfunding the health sector in India’s budget allocations and talk about how it will affect the country’s society and economy using relevant examples. (150 Words)
Why Budget is not Up to the Mark
- Poverty: According to a study, COVID-19 caused 230 million Indians to fall into poverty.
- Education: o The ASER report demonstrates the appalling state of education; many students in Class 5 are unable to read a textbook for Class 2.
- Health: According to NFHS-5 data, 32.1% of children under the age of five were underweight and 35.5% were stunted.
- In addition to a growing burden of communicable diseases, non-communicable diseases, mental health issues, and geriatric care are also on the rise.
- India lacks the necessary infrastructure, human resources, and access to affordable medical testing and care.
- Stable funding: The funding for nutrition and education is stable. Without accounting for inflation, the budget for midday meals was cut by 9%, despite data showing a shift in enrollment from private to public schools as private education becomes unaffordable.
Faultlines:
- COVID-19 brought three major fault lines into sharp relief: o The absence of financial risk protection, which is why citizens incurred significant costs, estimated to be more than 70,000 crores, even as their incomes declined; o A primary health system that was broken, particularly in the north, which led to a significant number of avoidable deaths; and o The lack of adequately staffed district hospitals to handle the demand.
- To address these, India needs a boost in resources and creative thinking.
- The chaotic state of the legal system.
- Many laws contain grave flaws and embedded conflicts of interest. In order to avoid disruption and harm patients, especially the poor, opening up the health sector to market forces needs to be modified in some cases and scrapped in others.
- COVID-19 emphasised the importance of public health investments in order to develop our disease surveillance system and increase resilience to such shocks.
Neglecting the health sector creates a vicious cycle
- Lack of investment in the health sector results in inadequate access to crucial health services, which raises the incidence of illness and disease. This vicious cycle is brought about by disregarding the health sector.
- Due to the lack of funding for the healthcare sector, there is an increased demand for healthcare services, which increases the financial burden on families and communities as they must pay for medical expenses out of their own pockets.
- Out-of-pocket costs lower people’s purchasing power and overall economic growth, which in turn lowers the government’s capacity to invest in the health sector. The vicious cycle of neglecting the health sector continues as inadequate funding results in subpar health outcomes and lower economic growth.
Need of the hour
- Expanding universal access to high-quality education, healthcare, and nutrition (not just food grains but proteins and other supplementary foods that are currently unaffordable) is crucial for the sustainable, long-term growth of the nation.
- By enhancing the healthcare system and lowering vulnerability, a government must protect its citizens from any such occurrence.
- To rebuild our public health system, advance scientific research, and increase health security, we require political leadership backed by adequate funding.
- To create a nation, a political system must be based on the principles of equity and justice.
- Measuring policy and financial allocation solely in terms of political expediency is a short-term and unsustainable strategy.
- The underprivileged and marginalised will suffer disproportionately when such structures collapse, which they will.
- Budget allocations should be made in a methodical way that inevitably takes into account the problem of growing inequality.
- Health investment: Building 157 nursing schools and attempting the impossibility of “eradicating” a genetic disease are not the solutions to these serious structural issues.
- The illness is an equaliser; during COVID-19, many wealthy people also passed away from lack of access to oxygen or a hospital bed.
- It’s important to keep in mind the cost we paid back then and the lessons we learned. Consequences result from underfunding and ignoring the health sector.
- Supporting Inclusiveness: India should take a cue from developed nations and allocate funds to support inclusiveness and lessen disparities in access to health and education services, especially for rural and marginalised populations.
- Promoting Public-Private Partnerships: To advance the development of these sectors and provide an additional source of funding and resources, India should investigate partnerships with the private sector.
Conclusion
- The social economist William Beveridge sought to address the “five giant evils: want, disease, ignorance, squalor, and idleness” when he envisioned a welfare state.
- If such articulation serves as the foundation for India’s vision, investments should be prioritised first towards necessities like food, health care, employment, education, environmental sanitation, and hygiene, rather than infrastructure projects like speedways, airports, and trains.
