Chapter 2 ROLE OF THE GOVERNMENT IN HEALTH

What Is Health

Health is a comprehensive concept that extends beyond merely being free from illness and injury. It encompasses aspects like having access to clean drinking water, a pollution-free environment, adequate food, and freedom from mental strain, anxiety, and fear. Being active and in good spirits in all activities is also considered vital for good health.

Healthcare In India

India possesses a substantial healthcare infrastructure, producing a large number of doctors and having numerous medical colleges. The country is also a significant exporter of medicines. Healthcare facilities have expanded over the years, with a considerable increase in the number of government hospitals. India also attracts medical tourists due to its world-class hospitals and advanced medical treatments. However, despite these advancements, a significant paradox exists: with all these resources, the country struggles to provide adequate healthcare to all its citizens. A large number of deaths occur annually from preventable diseases like tuberculosis and malaria, and a substantial portion of children suffer from malnutrition. The second column of information highlights the poor health situation, including the shortage of doctors in rural areas, the difficulty in accessing clean drinking water, and the high prevalence of water-borne diseases, indicating that all these positive developments have not translated into accessible healthcare for everyone.

Public And Private Health Care Services

Public Health Services

Public health services are a network of government-run hospitals and health centers that aim to provide healthcare to all sections of the population, covering both rural and urban areas. These services cater to a wide range of health issues, from common illnesses to specialized treatments. At the village level, health centers are staffed by nurses and village health workers, supervised by doctors at Primary Health Centers (PHCs). District hospitals oversee these centers, while major cities have multiple government hospitals, including specialized ones. Public health services are funded by taxes paid by the public and are intended to provide quality healthcare either free or at a low cost. A crucial function of the public health system is disease prevention and control, requiring organized efforts in areas like sanitation and public awareness campaigns.

According to the Constitution, it is the government's primary duty to ensure public welfare and provide healthcare to all citizens, safeguarding the Right to Life. In the case of Hakim Seikh, the court ruled that denial of timely medical treatment by government hospitals violated this right, and the State government was ordered to compensate him for his expenses.

Private Health Facilities

Private health facilities are owned and operated by individuals or companies for profit. They include private clinics, hospitals, nursing homes, and specialized laboratories offering services like X-rays and ultrasounds. Unlike public services, patients have to pay significant amounts for these services. While private facilities offer advanced treatments and comfortable environments, their high costs often make them unaffordable for a large portion of the population. This situation leads to many people, especially the poor, facing financial hardship and borrowing money or selling possessions to afford medical treatment. Some private practitioners may also engage in incorrect practices, prescribing unnecessary medications or procedures to increase earnings.

Healthcare And Equality: Is Adequate Healthcare Available To All

India faces a significant challenge where private healthcare services are expanding, while public services are not growing proportionally. This results in a situation where mainly private services, which are expensive and concentrated in urban areas, are available to many. The high cost of medicines and treatments makes it difficult for a substantial portion of the population, including those not considered extremely poor, to afford necessary medical care. Medical expenses often cause hardship, forcing people to borrow money or sell assets. The poor are particularly vulnerable, as they are often undernourished and lack basic amenities like clean water and adequate housing, making them more prone to illness. When illness strikes, the lack of affordable healthcare exacerbates their already difficult situation. Furthermore, women's health concerns are sometimes given less priority, and access to healthcare is limited in many tribal areas, with few functioning health centers and an absence of private services.

What Can Be Done

The Kerala Experience

Kerala made significant strides in improving its health situation by allocating 40% of its state budget to panchayats in 1996. This decentralization allowed local bodies to plan and provide for their specific needs, including water supply, education, women's development, and health. Improvements were made to health centers, leading to better planning and service delivery. However, challenges like medicine shortages and insufficient hospital beds persisted, requiring further attention.

The Costa Rican Approach

Costa Rica is recognized as one of the healthiest countries in Central America due to its deliberate decision to abolish its army. This allowed the government to allocate substantial funds towards health, education, and other basic needs of its citizens. The Costa Rican government prioritizes health as crucial for national development, providing essential services like safe drinking water, sanitation, nutrition, and housing. Health education is integrated into all levels of education, emphasizing its importance.

Challenge Of Democracy

The struggle for equality and the recognition of everyone's dignity is an ongoing challenge in all democracies. While India has constitutional provisions and government programs aimed at promoting equality, the challenge lies in changing deeply ingrained societal attitudes that perpetuate discrimination. The example of the US Civil Rights Movement demonstrates that legal changes alone are not enough; a fundamental shift in attitudes is necessary for true equality to be realized. Individuals and communities play a vital role in this continuous struggle to expand the meaning of democracy and ensure that all persons are treated with dignity.