The first wave of the Covid-19 crisis pushed nearly 23 crore Indians into poverty, estimates a study by the Azim Premji University. No one knows how many times the number has gone up in the second wave. Now it has been revealed that medical bills have pushed crores of Indians into poverty during the pandemic. The government’s shrinking share in in healthcare is stated to have pushed up medical costs, leaving many Indians teetering on the edge of a debt trap. The second wave has amplified the crisis. For all of India, ‘out of pocket’ expenses make up 63% or almost 2/3rd of the total expenditure. In Bihar, 99.9% of medical expenditure is private or ‘out of pocket’. That means, for every Rs 100 of medical expenses, only 10 paise comes from the government. Experts everywhere agree that government support in healthcare can be a safety net that catches people whose medical bills would push them into poverty. Economic Survey tabled this year before budget also estimated that an increase in government spending on healthcare from 1% to 2.5-3% of GDP can reduce private expenditure from 65% to 30%.
With detected Covid cases touching 3 crore, it is entirely possible that many lakh citizens needed hospitalisation over the last year. Last month, the General Insurance Council revealed that insurers had received over 15 lakh claims. But this could just be a fraction of total claims that come in. And lakhs more would have availed treatment without the benefit of insurance. The 2017-18 NSO survey on healthcare had pointed out that more than 80% of Indians had no health insurance cover. The same report also revealed that just 42% of patients sought in-patient treatment at government hospitals, pointing to the extent of private care dependence for low-income Indians.
For too long, most parts of India have underspent on public health. In 2018, just 4% of those who received in-patient medical care in Bihar government hospitals received free medicines. One of every five Below Poverty Line (BPL) households blamed medical expenditure for their plight. The latest Economic Survey also pointedly warned government of healthcare costs driving people to poverty, while suggesting a rise in public healthcare budgets to 3% of India’s GDP. Given India’s current unemployment crisis, such a boost in spending will also create lakhs of healthcare jobs. While Centre has rejected a PIL seeking Rs 4 lakh compensation for the Covid dead, governments must make an effort to figure out Covid hospitalisation-related indebtedness, and make special payments for most deserving cases. And if this crisis does not spur greater public health expenditure, we truly wonder what will.
But it hardly matters to the BJP government which is on a privatization spree of all sectors including health thereby laying the roadmap of further distress and debacle of the countrymen. (Source Times of India 21-06-21 and 22-06-21)