It's Time to Talk About Healthcare

Indian Policy Collective is announcing a series aimed at collating facts, figures and policy recommendations to inform the public health debate. Do read, spread the word, and write in.  

As India began to emerge from a stringent and devastating lockdown, news of its crumbling public health infrastructure began to filter in: lack of beds, of medicines, of basic hygiene, food and water, and care in wards, of hospital staff and of PPE and adequate compensation for them, and of means to lay the dead to rest with dignity. 

And yet none of this is surprising. India spends just about 1% of its GDP on public health, ranking 170 out of 188 countries on this count. A common misconception could be that India spends less on public health because it is a developing country and does not have the resources to step up the funding.In fact, India lags behind on health care expenditure compared with BRICS countries. It also spends too little on public health in comparison with its neighbours. As per the WHO, India finishes second from the bottom amongst the 10 countries of its region for the percentage of GDP it spends on public health.

In public hospitals the number of beds available per 1000 people is .5 and 12 states, that account for roughly 70% of the country’s population, lie below the national average. The number of ventilators and critical care beds are far lower. Rural India is the worst equipped when it comes to public healthcare, with certain areas lacking even basic and primary healthcare. Where care is available, standards are abysmally low. A Lancet study estimated that 4,300 Indians die every single day due to poor quality of healthcare. 

It is no wonder that nearly 70% of Indians incur out of pocket expenditure for healthcare due to which at least 7% of the country’s population is pushed below the poverty line each year. While private healthcare is more reliable on average than public healthcare, particularly in larger cities, overall its quality is drastically inconsistent. A large part of the blame, again, lies with the state for having failed to regulate healthcare in the private sector effectively.  

In a democracy, however, the buck for the repeated failure of elected representatives must stop at the electorate. The pathetic state of healthcare in India is a lived experience for most Indians. The pandemic has only served to exacerbate the toll it takes on citizens. Even so, it has not been an election issue in India. 

The first step towards mobilizing democratic engagement in the public health debate is collating facts, figures and policy recommendations and making them widely available. 

We, at the Indian Policy Collective, will be starting a series aimed at doing just that. Please follow it, share it, and send in comments and suggestions. 

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