Relevance: GS-2 : Issues relating to the development and management of Social Sector/Services relating to Health, Education, Human Resources

Key Phrases: Budget 2022-23, Tele-health programme, Cooperative and competitive federalism, health and wellness centres

Why in  News ?

• Recently, Budget 2022-23, highlights the need for the grand vision and strategy for health that the country urgently needs.
• The Tele-Health Programme For Mental Health, and allocation of Anganwadi Centres announced are appreciated across the health sector.

Editor's analysis of government efforts in health Sector

1. Poor fiscal capacity due to covid

   • The pandemic notwithstanding, or perhaps because of the Covid-19 pandemic, the fiscal space for health is small.
   • The country has incurred a large unplanned and unavoidable expenditure on Covid-19 vaccination.
   • Key priorities including national defence, education and subsidies cannot be set aside overnight.
   • Perhaps increases in taxes on tobacco to achieve improvements in health on non-communicable diseases were feasible, the finance ministry may have judged that it has little room to manoeuvre in a fragile economy.

2. Cooperative and competitive federalism:

   • The Union government only bears a third of total public health expenditures, and about 8 per cent of overall health spending.
   • States collectively spend twice as much on health as the Union government, and that is where the real action lies.
   • The significant divergence in health spending across states is one reason for the large variations in health outcomes nationwide.
   • Allocations to health by states like Uttar Pradesh and Bihar have greater bearing on the health of the average Indian than the Union Budget.

3. Budgetary Deficit:

   • It is unlikely that one year’s budgetary allocation to health can make a difference, without a long-term plan for deployment.
   • Thus far, that vision has not been forthcoming from this government, and where it has been articulated, has not been followed up with long-term commitments of investment with much specificity.
   • The much-vaunted health and wellness centres remain a distant dream.
   • Health insurance cannot be a substitute for universal health coverage.

Why investment in health is the need of the hour?

1. Expenditures on maternal and child health, and nutrition can pay off in terms of a more capable workforce.

2. Early investments in these areas improve cognitive ability and therefore, the capacity to acquire skills and education.

3. Investments in health provide financial risk protection to the population. Nowhere is this need greater than in India, where health expenditures are the number one reason for families to go into poverty, as has been particularly visible during the Covid pandemic.

Challenges in Health sectors: Population, Labour

• Population Explosion : The window of opportunity to implement a grand plan for health is small. The 26 million children born in India each year represent the largest numbers of new citizens to any country in any point in human history.
• Poor Investment : Without key investments early in their lives, we doom them to a future where they will be unable to compete globally for jobs and add to the unemployed masses.
• Quality of Labour Issues : Any business owner in the country knows that there are jobs aplenty -- it is the quality of labour that is available to fill these positions that is in shortage and that quality of human capital gets built early in life.
• Arbitrary benchmark of 2.5 to 3 percent of GDP spending on health is inadequate, Without a sustained 20-year plan to enable the country to reach critical milestones on
  1. Infant mortality (rates of which in some of the largest states in the country are comparable to those of sub-Saharan Africa)
  2. Nutrition (India has high stunting and anaemia rates compared to other similar countries)
  3. Child immunisation coverage (India lags neighbours like Bangladesh and Nepal)
  4. Reductions in Infectious diseases (India has high rates of tuberculosis, malaria, and antimicrobial resistance)
  5. Reductions in non-communicable diseases (rates of diabetes and obesity are high and rising).

Way Forward: Human capital, Learnings, Co-ordinated Efforts

• Human power is vital to become global power: India aims to compete with the leading countries of Asia in terms of economic growth.
•  Learnings from China: China’s singular achievement of pulling hundreds of millions out of poverty was based on an ambitious plan and commensurate investments made in health and education 50 years ago, that were then leveraged by a deregulated economy.
• The National Health Mission was the equivalent in India but need comprehensive reforms. .
• History shows that the country can achieve ambitious targets in health. It may be time for an annual health and education special session in Parliament, with all the pomp and ceremony of the Annual Budget.
• Co-ordinated efforts by different Ministries: The annual plan could be presented jointly by the honourable ministers of finance, health, and education -- the country’s health is too important to be left to the finance minister alone.
• By separating health budgets from the broader work of investing in health, the government could demonstrate India’s seriousness to improve the quality of capital of its most plentiful and valuable resource its citizens.

Source: The Hindu BL

Mains Question:

Q. Investment in education yields both individual and social returns, yet India's efforts in education sector are very unimpressive. Do you agree?