Congress president Rahul Gandhi on Friday announced that a right to healthcare Act would be included in the party manifesto for the 2019 Lok Sabha polls manifesto. Ahead of the Assembly polls in Chhattisgarh last year, T S SINGHDEO, who led the state manifesto committee, had travelled across the state and compiled a document of promises, including universal healthcare.
How is universal healthcare different from the system that’s in place now?
Universal healthcare as a right is a step ahead (just) as MNREGA is for providing employment… worldwide, society is moving towards providing healthcare as a right, rather than just as a service… There should be a law in place. The secondary aspect will be the financial implication… rest is logistics and management.
For a law like this, the state needs a healthcare system in place.
In Chhattisgarh, you have 70,000 mitanins (health workers) in place, you have 5,200 SHCs in place, 792 PHCs, 170 CHCs, 27 district hospitals, six medical colleges. Within this infrastructure, the population of Chhattisgarh can be serviced… What is lacking is manpower… (and) supply of drugs and diagnostics tools. Healthcare is looked at in three stages, primary, secondary and tertiary; 92-95 per cent need only primary and secondary healthcare. In a two-year framework, you should be able to supply medicines to the last point. . Click for more election news
How do you plan to do that?
By providing healthcare at the last point. If you have fever, or malaria, you need to be treated there, (you do) not have to come to Raipur… There are 5,200 SHCs and 20,000 villages, which is three or four villages per SHC. You don’t need to go to even the block headquarter.
Many will argue that it’s not possible to do this on a mass scale, which is why there are schemes like Ayushman Bharat.
You can provide for people here with no great expenditure. On insurance companies, are they Bill Gates? They will be taking at least a 10 per cent profit. If 10 per cent of profit is coming from public money, why is that not used in the public sector?
Where will the money come from?
The loan waiver is Rs 10,000 crore. But this is a one-time thing. We have not said that every year we will waive off loans. So next year’s budget, you have Rs 10,000 crore. It is very simple… When we launched the manifesto, Rahul Gandhi asked me, ‘how are you going to do it?’ I had said it will take Rs 20,000-30,000 crore to do everything at a time… All of these things, through planning, are achievable.
But why should someone not have the choice to go to a private hospital instead of a PHC, and get procedures done on a smartcard, as Ayushman Bharat promises to?
We are not competing with Ayushman Bharat. But what are the limitations of the insurance model? They start functioning only after you are an in-patient. Till you are admitted, service doesn’t start for you. The premium is paid for you, but your requirement is met out of pocket… The experience internationally, especially with Obamacare, is that the insurance model is feeding into the budgetary model… Choice will be open to anyone. We intend to raise confidence in the government sector.
Does that mean you are not pulling out of Ayushman Bharat immediately?
No, that will not make sense… It is a phasing out of the system… in terms of Chhattisgarh, the Ayushman scheme is misleading. The Centre is not providing for Rs 5 lakh care. Its premium covers only Rs 50,000. These are facts on record. The primary financial burden is anyway on the state government. So we can free that up if we invest in universal healthcare.