Let not focus on healthcare falter

India spends just over 1% of its GDP on public health compared to 2.9% by neighbour China and 14.3% by the US. This places it at a lowly 170th out of 188 countries on this count. India has just one doctor for 1,511 people, much lower than the WHO standard of one for every 1,000.

A study by Lancet had estimated that an average of 4,300 Indians die every day due to inadequate healthcare, far more than the rate at which people died of Covid. Another study by the government’s NITI Aayog shows that 78% of a citizen’s out-of-pocket expense on health is on pharmacies and private hospitals.

India’s public healthcare system is not just a victim of under-funding, but also of political apathy, corruption and an uncaring establishment that wakes up only when mammoth human tragedy strikes. The hopes of modelling our system on Britain’s NHS, which India’s neighbour Sri Lanka copied so successfully, were given up long ago and instead a token insurance cover system for 10 crore poor households was inaugurated more recently. 

Many hoped that the pandemic, which affected over 1 crore Indians and claimed the lives of 1.55 lakh citizens, would act as a wake-up call for the country to try and improve its public health infrastructure on a war footing. Unfortunately, that was not to be the case. According to PRS legislative research, the budgeted expenditure for the health ministry for 2021-22, at Rs 73,932 crore, increased by just 7% over 2019-20’s expenditure plan.

States and Union territories together spent about Rs 1.58 lakh crore on public healthcare in 2017-18 in contrast. A promise has been made that India will spend some Rs 64,180 crore over six years or roughly Rs 10,000 crore a year on building a new improved national healthcare system with primary, tertiary and secondary healthcare centres and hospitals under yet another Prime Ministerial scheme. While this sounds good, the allocations remain inadequate. The state should get its priorities right and start paying more attention to the health of its citizens.