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Public Health Systems and Privatised Agendas
Examining how health policy has fared in India during the last five years shows the constriction of finances for major programmes like the National Health Mission and Reproductive and Child Health Programme that has led to under-resourced public systems. The Ayushman Bharat Pradhan Mantri Jan Arogya Yojana health insurance scheme would only end up diverting public resources towards commercial insurance companies and private hospitals, while having doubtful benefits for community health.
The findings of a major study recently published in the Lancet covering 170 countries can be expressed briefly as follows: Democracy is good for health and health systems (Bollyky et al 2019). Life expectancy was found to improve more in countries which had democratic systems, and the “democracy effect” was far stronger than any effect of gross domestic product on population health. Various mediating sociopolitical processes were responsible for this positive correlation. The converse is also mostly true: the erosion of democratic institutions and processes in any country would be harmful for the health of its people. In short, constriction of democracy is bad for people’s health.
As India enters the general election mode completing the five-year cycle, it is appropriate to take stock of where our country stands, both in terms of ensuring democracy, and regarding the functioning of health systems. Assessing how democracy has fared in India since 2014 lies far beyond the scope of this article; here we will focus on a more modest objective: examining how the incumbent Bharatiya Janata Party (BJP)-led central government performed in the health sector over the last five years in key areas. We leave it to our knowledgeable readers to trace correlations between the condition of democracy and the trajectory of public health in India during the last few years.
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