Before the great crash of vanities that we are now witnessing, the flow of neo-liberal enthusiasm in the Indian middle class reached an unprecedented high in the last couple of years, stoked by the breathless encouragement of P.Chidambaram and Montek Singh Ahluwalia.
As people who are paraded frequently as the fount of economic wisdom, in the media and elsewhere, they should have seen the disaster coming. They didn’t. They should have had the grace, howsoever insincere, of Alan Greenspan in admitting that they had made a mistake. Again, they did not.
Nowhere is the legless exuberance of our ministerial masters and their dishonest bureaucrat mandarins more evident than in the business of healthcare. After successfully throttling State support for healthcare, except for a preventive programme, the National Rural Health Mission, the Manmohanomics brigade only let loose their insurance agents to hawk incomplete health policies to the financially and politically semi-literate middle class.
Some of us are in such a difficult situation, thanks to this deterioration, that we are compelled to take out a policy to avert catastrophic expenditure on a premature and non-fatal heart attack that may never come, or a cancer that may not strike. Yet, we are not taking chances, although, again, the mandarins are asking to cough up higher premiums each year for dwindling health cover (exclusions of diseases and conditions proliferate, drugs are not covered, and costs are increasing thanks to corruption in corporate hospitals).
With the collapse of the globalised economy, the only people who are comfortable about facing health expenditures are those who stashed away their corporate bonuses and filthy lucre, and the babus sitting in Passport, Sales Tax, Income Tax, Excise and RTO offices where nothing gets done without a bribe being paid.
We need to wield the stick on Government now. The year 2009 will again present us with an opportunity. The UPA is by far the best bet, because the other contender, the party of the bigots, religious and caste fanatics and big business, can only enhance the pace of damage being done to the Indian social fabric.
In the coming elections, therefore, we need to persuade the UPA to come up with a time-bound programme to implement universal health care, funded through state taxes or other institutional mechanisms, and not by cleaning out the pockets of citizens.
We do not have to develop an inferiority complex about this demand, because that is exactly the agenda on which the recent US election was fought, (many Indians love America and its way of life) and Barack Obama, who promised a new deal for America’s uninsured and underinsured citizens, won. We should do even better because we have a longer history of caring for people than does the US.
For many of us, universal, socialised high quality medicine is a welfare measure that should be available as a matter of right. That is the position prevailing in many developed countries in the world, notably Western Europe, UK, Australia and Canada.
To help us prepare our own health manifesto, a meeting of community-oriented people was held in Ranchi, Jharkhand on February 15-16, 2009. Here are the ten points they finalised:
Adopted at the two day workshop on community health, Ranchi, Jharkhand
1. Make Right to Health a fundamental Constitutional Right and enact a Right to Healthcare Act under which all Indian citizens can get easily accessible, quality healthcare services;
2. Stop privatisation of healthcare and abdication of the state’s responsibility for health of citizens in the country;
3. Raise budget allocation for health from the current 3 per cent of GDP to 5 per cent by 2012 and to 10 per cent of GDP by 2015; Allocate adequate portion of the health budget to traditional healthcare systems also;
4. Provide a minimum of 2,000 balanced calories per day to all Indian citizens and take all necessary measures to ensure this;
5. In compliance with the Supreme Court directive ensure quality and universal service provision in anganvadis to all girl children, women and all those in the age group 0-6.
6. Provide pregnant and lactating women daily financial support equivalent to the daily minimum wage for a period of six months (three months before and after child birth);
7. Provide emergency interest free loans to all citizens for meeting non-health related expenditures during illness;
8. Enact a Rational Drug Policy that allows the sale of only generic drugs and also limit the patent holding rights on all drugs to a maximum of five years;
9. Cancel the licenses of all industries causing pollution and recover full damages to the affected people as also to the environment;
10. Protect the basic human rights of all citizens guaranteed in the Indian Constitution and prevent violation of these rights by both state and non-state agencies, including in times of natural or man-made disasters;
In addition, some demands specific to Jharkhand were also made
Start nutrition rehabilitation centres for malnourished children;
Enact a Nursing Home Regulation Act immediately;
Provide financial support equivalent to the prevailing daily minimum wage to those undergoing de-addiction therapy, for the entire period of the treatment.