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My Health, My Right

Dr. Elsa Lycias Joel Dr. Elsa Lycias Joel
08 Apr 2024

After so many fell prey to pranks on April 1, Indians had enough entertainment with trending hashtags such as #FekuDiwas, #FekuKaTimeJayeega and #ModiMatBanao. Students went to the extent of requesting the President to rename April 1. When I thought about what comes next, April 7 popped into my mind. I was reminded of Ayushman Bharat, a new scheme made on the RSBY (Rashtriya Swasthya Bima Yojana) template. Since the BJP is known for expanding the welfare programs of Congress, no one was surprised. It made no sense at all for many reasons. However, I will mention only 12 because, unlike in the West, the number 13 is considered auspicious, and the ruling government might assume they still have a chance to introduce more such schemes to channel public money to the private sector.

1. In a diverse, multilingual country, not everyone understood what Ayushman Bharat meant.
2. The claim that this scheme, which sounded like a tongue twister, provided each household insurance cover of Rs 5 lakh was a colossal fraud.
3. Names such as Pradhan Mantri Jan Arogya Yojana (PM-JAY) confuse people, especially the prefix.
4. Diabetes and Blood Pressure, two common ailments, aren't covered.
5. It was covered in national newspapers 212 times more than RSBY, 40 times more than NHM (National Health Mission) and 37 times more than HWCs (Health and Wellness Centres).
6. I found nothing "historic" or "revolutionary", as the media described it.
7. The CAG report revealed that 3.67 crore of the 11 crore beneficiaries were suspicious, and 1.69 crore were fake.
8. 7.5 lakh beneficiaries were linked with a single mobile number in the BIS database. Did they all belong to the Vasudhaiva Kutumbakam?
9. It's unbelievable to know that even the dead had availed the benefits of this scheme. But, if children are made to believe that a full-grown man flew out of the Andaman jail on bulbul birds, why should I doubt the dead coming to life just to visit hospitals?
10. In short, the government decided to purchase services instead of providing them.
11. Unfortunately, the HWCs were not immune to the name change drama.
12. NHM and RSBY are strangulated.

Using the initiatives of the Congress as a template is fine as long as the ideological commitments are in tune with those who formulated the scheme. I doubt whether the ruling government is competent enough to take public health seriously. Should we be retold about how this right-wing government failed the Indian people, including the farmers, during the COVID pandemic? An astounding level of incompetence, I would say. Remember the Gujarat model? The Civil Hospital in Ahmedabad saw 377 deaths as of May 22, 2020, accounting for 45% of the total deaths in the state. Worse, the Gujarat High Court called it "as good as a dungeon". Vaccine-maker Serum Institute of India Pvt Ltd was among the top 10 donors through electoral trusts. Does it ring a bell as to why vaccines were forced on people? Despite a good template, the RNA polymerase can still malfunction, which could be fatal to the cell. Genetics is all about complementary base pairing, so RNA polymerase's error rate is 1 per 100000 nucleotides. Sadly, extremism complements nothing good and pairs with violence.

Considering the government's health schemes, most procedures are paid under the scheme only when availed in a public or private hospital after referral from a public hospital. Why can't the money allocated for PMJAY be used to strengthen the public health system? Make no mistake, we need welfare schemes that translate into real-time results. Allocation to schemes and public health facilities must be done in a balanced manner. If the leader of our country feigns ignorance about the roles that the public health systems are supposed to play, it is high time we choose a responsible leader.

Excessive and obsessive focus on schemes that are implemented half-heartedly needs serious rethinking. Public facilities do not refuse treatment on financial grounds, unlike private facilities. The debate should be about something other than whether the Public Health services need serious reform. Policy analysts of most political persuasions agree that it does. Instead, the question is whether ruling governments should honestly prioritise health care, improve public-private coordination, expand people's choice and control over their health or launch the best government healthcare system in sync with lofty promises, on par with world-class standards. If one-third of the electoral bonds are used to upgrade public facilities, Indians won't have much to complain about. What would it convey about my integrity if I manage a hospital with qualms about availing its services? We all know why class I and II officers do not prefer their children to study in government schools. For obvious reasons, bureaucrats and politicians rush to private hospitals for regular health checks.

I hail from Tamil Nadu and know we care deeply about healthcare. We have never felt the need for a central university or AIIMS. We are blessed with several renowned universities and medical colleges established before the Independence, not the independence BJP's poster girl screeches about. That one brick in Madurai is an added motivation for Tamilians to wave black flags and shout slogans whenever necessary.

Empathy is the robust and unshakable foundation on which Christian Medical College, Vellore, was founded by Ida Scudder. Committed to truth and high ethical standards, CMC thrives and flourishes with its army of professionally excellent, ethically sound and compassionate individuals.

High aspirations or declarations of good intentions amount to little or nothing when 2.1 %(2023) and 2.2% (2022) of GDP, against 1.6% (2021), were allotted towards healthcare. According to Sanjeev Singh, Medical Director at Amrita Hospital in Faridabad, the GDP allocated for healthcare is only 1.9 per cent.

India's policy decisions directly affect the lives and well-being of all Indians, especially those wallowing in multidimensional poverty. No scheme is worth its salt without honesty, empathy, commitment, and perseverance. Formulated with the best intentions, schemes might go up in smoke when the implementers play foul.

When courts, lawyers, political parties, activists, environmentalists and citizens were grappling over the multidimensional levels of pollution caused by Vedanta's Sterlite Copper plant in Thoothukudi that resulted in the shooting down of 13 lives on May 22, 2018, the government at the centre remained mute. Public health problems were at its peak in Thoothukudi. Do we need another reason to believe that the PM's health schemes are an eyewash?

Public health, government projects and other welfare measures are all interconnected. Vedanta Ltd is regularly pulled up for environmental violations across India but has yet to be brought to book. Bonds worth Rs 25 crore were bought by Vedanta in January 2022. Who will teach the PM that human lives are invaluable and indispensable? As per the recent data released by the SBI on March 14, 2024, Vedanta has bought bonds worth Rs 400.65 crores. As and when this group bought bonds, it continued making places unsafe for human existence and natural resources unsuitable for human consumption.

Trust me, human health is never on the government's list of priorities. Clean water, air, soil and food are our birthright. Black gold will continue to shine, and fly ash will suffocate us if we don't claim our birthright. By denying all that is required for our physical well-being, citizens are subjected directly or indirectly to severe stress. May we be resolute in choosing our leaders with wisdom and forethought so that our lives are not taken for granted?

Be aware that the devil is in the details.

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