While the BJP manifesto neglects medicare for all, approach of Congress on healthcare makes good sense
With the election fever picking up, the blame game is increasing with every passing day. Issues concerning the people are not being highlighted as they should have been. The ruling party has very cleverly brought the rhetoric against Pakistan as a core issue. The speeches by the first rank leadership are by and large ignoring the issues of health and education. Even though the points related to healthcare have been mentioned in the manifestos of the various parties but until and unless they are emphasised by the leadership in their public discourses time and again, these do not become part of people's mind. A critical analysis of the manifesto of two major parties shows some differences in the approach.
The manifesto of BJP is centered around eulogising the Ayushman Bharat which is said to cover 50 crore people for in-patient care only. It nowhere talks of how to get the rest 80 crore people in the scheme in the future. Moreover, it does not give any proposal of bringing the people seeking outpatient care only in the scheme. Thus it sans any step towards universal healthcare. It talks of opening more medical colleges but does not give any information on whether they will be in the public sector or the private sector. This is important because the number of medical colleges opened in the last few years is more in the private sector. These colleges are charging exorbitant tuition fee which makes them out of reach of even the middle-class families. The manifesto also does not talk about increasing public spending on healthcare which is essential for ensuring quality healthcare to the common citizens.
The manifesto of Congress party recognises the healthcare as a right of every citizen. It promises to increase the public spending from present 1.1 to 3 per cent of the GDP by the year 2023-24 with step by step increase in every budget. What is needed is an immediate increase to 2.5 per cent of the GDP to be raised to 6 per cent in the next five years. The manifesto promises to enact Right to Healthcare Act 'that will guarantee to every citizen the right to healthcare services, including free diagnostics, out-patient care, medicines and hospitalisation through a network of public hospitals and enlisted private hospitals'. That the manifesto recognises insurance-based model not a preferred model to provide healthcare is a welcome note. It promises to implement free public hospital model to provide universal healthcare. Increasing the number of doctors by establishing more medical colleges, providing scholarship and loans to medical students.
The manifesto of the left parties highlights the right to free health as a fundamental right. Increase in public health spending to 6 per cent of the GDP, end to commercialisation of medical education. Strengthening of public health facilities, fixing the drug prices based on their cost of production and enact patent laws favourable to our country.
However, these are documents which are important in a way that the governments to come can be questioned on their performance based on the promises made in the manifesto. But what is lacking is a special forceful emphasis in public speeches by political leaders. This reflects a lack of sensitivity to health issues to the required level even though it is admitted that nearly 6 per cent of the population is pushed below the poverty line because of catastrophic out-of-pocket expenditure on health. There are also reports that financial stress as a result of out-of-pocket healthcare expenditure is an important cause of suicide among farmers. It is time for the public to act and force a pro-people healthcare discourse.
(Dr. Arun Mitra is Vice President, Indian Doctors for Peace and Development. The views expressed are strictly personal)