Where is health in the stimulus package? 

#GS2 #Governance #Health 

A part of the relief funding must be used to improve the country’s health infrastructure 

  • India can pause and breathe a sigh of relief in its efforts to contain the spread of the coronavirus.  
  • Though the situation varies across States, at the end of the first innings, the country seems to have an advantage. 
  • Credit for containing the spread of the virus should go to our frontline medical and health workers in government who literally rushed in where angels fear to tread to save people’s lives.  
  • Putting aside threats to personal safety, family interests, and stigma, selfless government health workers across the country are the ones who are leading the charge. 
  • India's GDP growth for 2019-20 was lowered to 4.1% from 5% projected by several agencies before the outbreak of the virus.  
  • Recent reports predict that the impact of COVID-19 might reduce GDP growth rate to 1.1% or even lower in the current financial year.  
  • Unemployment has been growing since January 2020 when the first cases of coronavirus emerged.  
  • According to the Centre for Monitoring Indian Economy, India’s unemployment rate at the end of May 16, 2020 was staggeringly high at around 24%. 
  • The second reason why the pitch isn’t in India’s favour is because our healthcare delivery system in most States is extremely fragile.  
  • One wonders, for instance, whether Bihar can handle the consequences if the virus begins to spread with the return of millions of migrant workers back to the State.  

Restoring livelihoods 

  • During this innings break, discussions on the strategy to win the match have been focusing on ending the lockdown, reviving economic activities, restoring livelihoods, addressing concerns of hunger and starvation, stimulating small and medium enterprises, and enhancing farm incomes.  
  • The package of ₹20-lakh crore, equivalent to about 10% of India’s GDP, announced by the Prime Minister on May 12, is expected to restore the livelihoods of millions of migrants and other workers who have lost their jobs and also enable entrepreneurs and businesses to get re-started. 
  • While it is too early to comment on the impact of these announcements, one should not forget that the fear factor in reviving employment and business is real.  
  • Equally disconcerting for them are the difficulties in and consequences of not adhering to conditions set by the government.  
  • This could well be a reason why, according to recent reports, in the midst of the long-term structural shift from China, companies prefer to relocate manufacturing to countries in the Association of Southeast Asian Nations (ASEAN) region, and not India. 
  • While economic stimulus packages are essential, the match cannot be won without urgently and immediately stepping up investments in health. 

Strengthening public health 

  • Dealing with the COVID-19 pandemic has brought out the critical importance of the public sector in health provisioning.  
  • However, stuck at around 1.15% of GDP for well over a decade, the low level of public spending on health is both a cause and an exacerbating factor accounting for the poor quality, limited reach and insufficient public provisioning of healthcare.  
  • The Union and State governments seem to have found the financial resources to provide an emergency response to deal with the pandemic.  
  • With agility and speed, orders have been placed for PPEs, ventilators, testing kits, and other supplies needed to detect and treat COVID-19 patients.  
  • It is possible that resources allocated for other health programmes are being diverted to deal with the COVID-19 pandemic.  
  • Media reports point out, for instance, that people’s access to routine maternal and child health as well as family planning services in parts of the country has been negatively impacted.  
  • The pandemic has exposed a hard truth: most private healthcare providers seem to be incapable of and unwilling to help even during a national crisis.  
  • According to recent figures, the private sector accounts for 93% of all hospitals, 64% of all hospital beds, and 80-85% of all doctors.  
  • Rapidly declining revenues and sharply eroding profits are leading to the closure of many private hospitals. 
  • This is the time then to seize the opportunity and invest in universal health coverage (UHC) by reversing the financial neglect of public healthcare.  
  • Nearly every country in the world that has achieved anything like UHC has done it through the public assurance of primary healthcare. 
  • Announcing a new ‘health investment plan’ (as part of the stimulus package) is the urgent need of the hour.  
  • At least 1% of GDP out of the stimulus package should be earmarked for improving the country’s health infrastructure and strengthening public health service delivery.  
  • And up to 70% of the additional expenditures should be ring-fenced for primary healthcare and further strengthening health and wellness centres, primary health centres and community health centres.  
  • There is only one way to win this match and establish a self-reliant and prosperous India: seize the opportunity and step up investments in public health across the country. 
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