The Hindu Newspaper Analysis – 21-10-2020

Lows in the Indian Health care system

  • India’s healthcare is composed of 70% private hospitals and 30% public hospitals. 80% of people do not have protection for their healthcare and the out-of-pocket expenditure stands at 62% which is very high. India also suffers from low expenditure on health at 1.13% of GDP added to this there is dearth of healthcare workforce in the country.
  • Today we see that 85% of the population cannot afford high cost, corporate health care and this is the specialized treatment with specialist doctors and equipment. Since, they can’t, insurance comes into picture.
  • We can talk about the Ayushman Bharat scheme where we have around 12 crore card holders and only 1.27 crore card holders have taken advantage of the same. All the private sector hospitals are driven by profitability and return on capital and this insurance only gives them space to expand the bills of the patients even though they don’t get attended in the best interests. While some procedures will be applicable under insurance, some do not.
  • Social insurance has solved the problem of pooling equilibrium where majority couldn’t afford quality healthcare. Still the hazard of the inefficient attention ails the people.
  • Talking about health economics, the aspect of competitive equilibrium doesn’t come into picture as the private and corporate hospitals are skewed towards profitability.
  • Primary health care, secondary and tertiary health care insurance and some of the most neglected things in this regard which further erodes the healthcare system in India. India’s health problem is characterized by a 80:20 rule where 20% people can afford modern health care, the first 40% among the 80 cannot do so at all where the rest 40% struggle to do and push themselves into the brackets of poverty.
  • People, due to the issue of access and affordability, reach the registered medical practitioners who fill them with unnecessary antibiotics and steroids that contribute to the problem of anti-biotic resistance.
  • How can this be bettered?
    • We need to ramp up the number of doctors and provide them with the responsibility in the rural areas as well.
    • Revive the idea of the licentiate medical practitioners which we had pre-independence era.
    • We need to empower those graduates with BSc in Nursing to be practitioners and add to the workforce.
  • The primary health in this regard needs more and more attention and the article says, the funds that are provided have to be doubled so that basic issues can be sorted.
  • The ratio of nurses to doctors in India is 0.06 nurses per one doctor which according to the WHO should be 3 per doctor and in the states like Uttar Pradesh and Bihar it is even lower.
  • Hence all these scenarios have to be considered and we need to focus on the small level and the grassroot scenario for our larger picture be bettered.

Maharashtra’s Shakti Bill

  • This article talks about the negatives in the Maharashtra’s Shakti bill that aims to better the scenario of sexual violence on women and points the redundancy in the same. The authors believe that it follows the same old conventional method and doesn’t speak about bettering the implementation in any way.
  • The authors add that this suffers from similar cliches like wider definitions, stricter laws and more authorities.
  • A robust investigative mechanism needs to have:
    • Fair and just laws
    • Robust investigative mechanism
    • Dynamic judiciary and
    • Adequate infrastructure
  • Though several changes were made after the Nirbhaya case and the recommendations of the Verma committee were implemented, implementation and infrastructure have to be taken care of in the right manner.
  • The various issues in the bill are as follows:
  • Patriarchal ideas
    • The bill proposes to punish false complaints and fake information and this adds fear in the minds of women to go ahead with the complaint as they fear that it would be disproven and lead to counter cases. Also, the occurrences of sexual violence are mostly happening behind close doors so there are rare chances that it will be proven.
    • This also paints women as manipulative liars and unworthy of being trusted.
  •  The bill provides for death penalty to heinous crimes but the very word of ‘heinous’ crimes is not defined and it is left to the discretion of the courts. It is often seen that the judges do not opt for death penalty as we have seen in most cases. Though death penalty has been previously mentioned in several laws, it has not acted as potent deterrent in this regard.
  • The accused in such cases are the family relatives of the victim in most cases and as a result, the victim will be mostly stopped by the family to take this forward.
  • Another provision is that the bill says that the investigation should be completed in 15 days, trail in 30 days and appeal in 45 days and it doesn’t provide to what happens if the trail is not completed within the stipulated time and duration.
  • Also, there can be huge space of mistakes that can take place and miscarriage of justice due to minute faults. We have seen this in previous investigations that this has happened. This is not just keeping the life of the victim at stake but also that of the accused and the career of the investigating officer.
  • The author adds that these are redundant proposals and the offences and punishments in this regard are mentioned in statues like the IT Act, section 354E of the IPC and so on.
  • Hence it can be said that instead of having such proposals that are redundant and conventional in nature, we need to focus on the implementation and the infrastructure to deliver effective justice to the people.
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      Dr. RS Aggarwal
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