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Public healthcare need not be such a let-down
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Context
The disparities in healthcare expenditure in India highlight significant inequalities. The Household Consumption Expenditure Survey (HCES) of 2022-23 brings to light the critical issue of unequal access to healthcare, underscoring the need for systemic reforms in the public healthcare sector.
Disparities in Healthcare Expenditure
- Survey Findings: The HCES reveals stark disparities in healthcare spending between rural and urban areas. In rural India, monthly medical expenses per head are ?89 for hospitalization and ?180 for other health needs, compared to ?123 and ?258 in urban areas.
- Income-Based Inequality: The top 5% of the population spend over 100 times more on hospital care than the bottom 5%. When analyzed further into percentiles, the disparity between the richest 1% and the poorest is even more pronounced.
- Implications of Averages: These averages are misleading, as they mask the reality of massive hospital bills that many cannot afford, highlighting the unequal burden of healthcare costs.
Challenges in Public Healthcare Access
- Dependence on Private Sector: Due to the inadequate state-run healthcare system, those struggling financially often resort to private healthcare services, leading to significant out-of-pocket expenses.
- Systemic Failures: Public figures opting for private healthcare is indicative of the failing public system, which lacks the trust and capability to provide quality health services.
- Cost Implications: While medicines remain relatively affordable, the high cost of private healthcare services exacerbates financial strain on the majority.
Policy Responses and the Way Forward
- Ayushman Bharat Scheme: The scheme has expanded insurance coverage significantly, with 345.6 million cards issued and almost 30,000 hospitals empaneled. However, it involves complex eligibility and treatment checks, falling short of universal healthcare.
- Universal Healthcare Necessity: A system providing high-quality healthcare to all without barriers, as seen in welfare states, is essential for equitable access.
- Government Priorities: While investing heavily in infrastructure, the government must address public healthcare gaps to achieve the Viksit Bharat ambition of a developed India by 2047. Immediate and massive upgrades in public healthcare infrastructure and services are crucial.
UPSC Mains Questions:
Q. Evaluate the effectiveness of the Ayushman Bharat scheme in addressing healthcare disparities in India. How does it compare to the concept of universal healthcare in equality-oriented welfare states?
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