Hardly a day passes without a news media report of a major violation of the right to health and healthcare in our country. The state of the healthcare system is such that those who are the most vulnerable are still the least likely to receive quality healthcare to live healthy lives.
Interestingly, in the 2019 election manifesto, Congress has promised to enact the Right to Healthcare Act. The Right to Healthcare Act would guarantee every citizen of this country, healthcare services. In other words, all contacts between patients and doctors, all diagnostic investigations, and all medical and surgical treatments would be made entirely free.
The Congress’s proposal for healthcare is a counter to BJP’s Ayushman Bharat scheme. While it is heartening to note that healthcare is finally receiving attention from the political parties, one is not sure if they would walk the talk (after the verdict) given their poor track record of keeping poll promises.
Contrasting Congress’ RTH with BJP’s AB
By focusing on the Right to Healthcare Act, the Congress is promising universal healthcare (UHC) to the people. Since ‘universalism’ is embedded in its approach, it has a better potential of reaching the ‘unreached’ – the poor and marginalised population groups – than targeted schemes like Ayushman Bharat Yojana, which focus only on the bottom 40% of the population.
Research shows that in case of targeted schemes, the mechanisms used for identification of the poor are often faulty and end up benefiting the non-poor while excluding the needy. Furthermore, the Ayushman Bharat scheme hardly offers anything to poor people who do not even have access to primary care.
Another issue is the ‘missing middle’. Despite the fact that one in four Indians is hypertensive, almost every tenth is diabetic and the prevalence of heart disease and cancers is very high, there is nothing for the middle-class in the Ayushman Bharat scheme, even as they incur high out-of-pocket expenditure due to these illnesses.
In light of that, Universal Healthcare as a concept, without a doubt, is far more appealing. However, one must not forget that Congress had also promised ‘health security for all’ in 2009 but after assuming office, it did nothing to further that promise, except implementing the Rashtriya Swasthya Bima Yojana (health insurance for the BPL families) which only benefitted the private insurance industries and private providers.
Taking a cue from Congress, the BJP, which had promised ‘Health Assurance for all’ in its 2014 manifesto, after coming to power, continued to support the RSBY and relaunched the RSBY with some cosmetic changes as the Ayushman Bharat (PMJAY) just before the election season, which is now being sold to the people as universal healthcare. – The Wire