Edit & Opinion

Healthcare System: Need for donation-free budget

A great teacher of ancient Greece is still remembered for stating that God’s existence can neither be proven nor be disproven. He would charge exorbitantly for teaching his pupils. Not surprisingly, most of his pupils were rich. But once he took a working-class pupil, Euthalos, who persuaded him for deferred payment. He gave the teacher his word of honor that he would pay his fees the day he won his first court case. But Euthalos gave up his legal practice before winning a case. The exasperated teacher took his pupil to court for non-payment of his fees and argued, “If I win the case, Euthalos will have to pay me what he owes to me and if I don’t win the case he will still have to pay me because, under our agreement, he will have won his first court case, Euthalos, however, contested his claim, stating, “If I win the case I’ll not have to pay Protagoras as the court would have declared his claim invalid. But if I don’t win the case, I still don’t have to pay as I would have then lost my first court case.” This remains one of the unresolved paradoxes of logic and is known as Protagoras paradox quite similar to the contemporary health paradox.
Donations are pouring in across the world to fight the pandemic of COVID-19 with an inevitable question arising, will such donations suffice to fight the pandemic? If yes, why is there a need to create a separate health budget? If not, why is there a need to create a health budget which sustains without donations? Countries worldwide have been fighting wars for years together, none of us has ever heard donations being made to governments to fight such wars. The juxtaposition of my question and answer gives rise to a statement of having security budgets priority over health budgets. The inevitable need has risen to frame health budgets independent of donations with a separate limb for contingency fund allocation for health crisis like that of Covid-19. National budgets of almost all the countries across the world share the symmetrical approach with regard to the allocation of funds for healthcare systems with defence budgets taking lion’s share.
The Protagoras paradox in prime consideration, the people at the helm of affairs hardly lend an ear to saner voices to keep their avenues open for exploitation and advancement of their political careers with least consideration for the lives of medics and paramedics. Their political advancements depend heavily on the funding of mafias who control their dictations even in framing legislation governing the same subject while such farce legislations continue to be mooted by Euthalos like law students in classrooms without benches and lights guided by Protagoras like teachers.
The Indian budget of 2020 saw an outlay of rupees 30 lacs, 42 thousand and 320 crores, 12.7 percent higher than the revised estimate of the financial year 2019-2020, with a modest sum of rupees 67 thousand and 484 crores allocated for against the sum of rupees 63 thousand and 830 crores in the year 2019-2020. Though this figure may sound huge for us, the truth is that this allocation amounts to a meagre 1.2 percent of GDP of the country, with India ranking amongst the lowest spending countries on healthcare. The instant allocation falls way behind the target spending on healthcare which is estimated at 3.5 percent of the current GDP amounting to  2 lakhs and 60 thousand crores. These figures seen in an isolated prism may seem impressive but they actually are very concerned when seen in relation to country’s budget on other areas which are prioritised over a basic right which every citizen must have.
By this analysis, it can very well be imagined how much parity is being followed against the basic right of healthcare visa vis farcial concept of national security where defence budget nearly accounts for 7 percent of the country’s budget. Some of the world’s lowest-income countries spend 1.4 percent of their GDP on healthcare. The nutshell of this cacophonic statistical analysis is that India spends 1.2 percent of overall expenditures against the 11 percent of GDP spent by some low-income countries. Much celebrated health schemes like Ayushmaan Bharat have been launched with a huge fanfare but core healthcare sectors have taken a hit.
Further analysis of various components of the overall health budget and national health mission show that this drop in health budget is primarily coming from the government pulling out funds from various components of maternal, reproductive, child health and communicable diseases components of the consolidated health budget. While one of the most important limbs of the health budget is research and development.
Research plays an important role in discovering new treatments and making possible use of existing treatments in the best possible way. Research finds answers to unknown things, filling gaps in knowledge and changing work of professionals, diagnose diseases and prevent their recurrence, to improve survival rates and improve quality of life. But all of this is not possible in a milieu where an ‘E’ grade researcher at the country’s most prestigious research centre DRDO gets a meagre salary of rupees one lac twenty-five thousand per month against a cricketer who holds the contract in “A” group earns a hefty sum of 10 million in a year. The apathy of a healthcare researcher can be well imagined seeing the infrastructure facilities of hospitals and research centres compared to that of an athlete.
Many a time there have been national headlines of athletes es and sportspersons suffering from deficiencies of infrastructure and hygiene while even vicious attacks on healthcare professionals hardly make it to rapid-fire news segment of media. Such is the shortcoming of infrastructure in the healthcare system that healthcare is apt to be used as a synonym of shortcoming when a mere thousand COVID patients have chocked the entire healthcare system of the country.
Like wars pandemics come out of nowhere, the current pandemic has bitterly exposed the existing healthcare system with deaths counting in lakhs but yet a single head is to roll. Time has come to take the budget of health at least to a near vicinity of defence budget if not equalizing it. For wars, a country needs healthy soldiers or to at least treat wounded soldiers in good hospitals. Recreations like that of sports don’t fetch taste once a spectator isn’t healthy. Some day or the other Protagoras like teachers or Euthalos like students may come to resolve the paradox but general public and healthcare warriors till that time need to be rescued from the present Corona paradox otherwise every side will have to pay unlike in the case of Protagoras paradox.

 

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