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  • India has never spent more than 2% of its GDP on healthcare.
  • Healthcare facilities across the country straddle different levels of efficiency and sufficiency.
  • This Pandemic has opened the eyes of people to the importance of universal and robust public health services and the need for everybody to be covered by quality healthcare, or for health services to be accessible to everyone.
  • There is a huge amount of the cost of this whole pandemic, total lack of preparedness for it and that it can strike everybody.

Agenda of healthcare as a Fundamental right: Universal Healthcare

  • This is a ripe time to actually take forward the agenda of right to healthcare and making healthcare universal.
  • Making healthcare a right means changing it from being treated like a commodity that can be purchased on the market.
  • In classical economic terms, this is a public good, it is a good with a very high degree of externality.
  • The idea was that if we give immunisation and some antenatal care, that’s enough, but that’s not the case.
  • We need very good disease surveillance; we need an integrated primary care system that can deliver in the field. We need tertiary care with the most sophisticated of ventilators.
  • If the public takes a greater interest, then obviously, governments also have to respond. We can achieve access to quality healthcare for everyone in the coming 5-10 years in most States across the country and as for a budget, around 3-4% of the GDP for public healthcare.
  • Publicly organised healthcare, would be a good starting point for putting in place at least a basic kind of universal healthcare (UHC) system.

Way things are being handled now:

There are States whose main approach has been to re-purpose existing hospitals providing comprehensive, tertiary, secondary healthcare for COVID-19 and patients that are therefore pushed out because of this, have to either seek care in the unaffordable private sector.

In States such as Kerala – public health services have done a remarkable job of containing the spread of the epidemic, especially through their primary healthcare activities.

Issues with the draft proposal for Universal Health Care

  1. The right to health and the right to healthcare are different things. The right to healthcare is enforceable in a certain way, but in this context, the right to healthcare is something that should be done immediately.
  2. Healthcare is a State subject. Making it a state subject could facilitate Central Money to flow, however, even the response to this pandemic shows that actually that doesn’t work.
  3. Getting the resources that are required is another issue. The middle class, the upper class, the ruling privileged persons will have to pay a price if you want a metric of equal health quality.

Establishing a Universal Healthcare System

There are a few constraints, considering that currently we have a fragmented health system. We have one health system for the poor, another for the middle class and another for the rich and the super rich. What we need to do is to move from this fractured system towards a single healthcare system for everyone.

The idea that the government can regulate private hospitals, harness them in public interest will remain.


  • Today, it is the public system, with all its problems, that has risen to the occasion.
  • So, in this sense, even the ‘worst public health States’ have stood by the people. But it doesn’t mean that the private sector has no role.
  • We need for the private sector, a much clearer regulatory regime and ways of contracting that are useful and it is most important that they supplement, not substitute, the strengths of the state.

-Source: The Hindu

November 2023